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01-12-2021 | Prostate Cancer | Research

Denonvilliers’ fascia acts as the fulcrum and hammock for continence after radical prostatectomy

Authors: Xuwei Lu, Chang He, Sihong Zhang, Fan Yang, Zhuifeng Guo, Jiaqi Huang, Minke He, Jiawen Wu, Xia Sheng, Wenyao Lin, Jie Cheng, Jianming Guo, Hang Wang

Published in: BMC Urology | Issue 1/2021

Abstract

Background

Radical prostatectomy (RP) is the primary treatment of localized prostate cancer. Immediate urinary incontinence post-RP was still common and depressing without specific reason.

Methods

A multicenter cohort of 154 consecutive patients from 2018 to 2020, who was diagnosed with localized prostate cancer underwent either modified mini-incision retropubic radical prostatectomy (Mmi-RRP) or laparoscopic radical prostatectomy (LRP) or robotic-assisted radical prostatectomy (RARP). Seventy-two patients with Denonvilliers’ fascia (DF) spared were included in DFS (Denonvilliers’ fascia sparing) group. Whereas eighty-two patients with DF completely or partially dissected were set as Group Control. The primary outcome was immediate continence (ImC). Continuous data and categorical data were analyzed with t-test and Chi-square test, respectively. Odds ratios (ORs) were calculated with logistic regression.

Results

Urinary continence of Group DFS was significantly better than that of Group Control at each time point within one year after operation. Incidence rate of continence in Group DFS and Group Control were 83.3% vs 13.4% (P < 0.01) for ImC, 90.3% vs 30.5% (P < 0.01) at 3 months, 91.7% vs 64.6% (P < 0.01) at 6 months, and 93.1% vs 80.5% (P = 0.02) at 1 year after operation, respectively. Positive surgical margin (PSM) showed no significant difference (20.8% vs 20.7%, P = 1.0). In multivariate analysis, DFS showed importance for ImC post RP (OR = 26.4, P < 0.01).

Conclusions

Denonvilliers’ fascia acted as the fulcrum and hammock for continence post RP. Preservation of DF contributed to better continence after RP without increase of PSM.

Trail registration Our research was conducted retrospectively and approved by the ethical committees of Minhang Hospital, but not registered.

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Title: Denonvilliers’ fascia acts as the fulcrum and hammock for continence after radical prostatectomy
Authors: Xuwei Lu
Chang He
Sihong Zhang
Fan Yang
Zhuifeng Guo
Jiaqi Huang
Minke He
Jiawen Wu
Xia Sheng
Wenyao Lin
Jie Cheng
Jianming Guo
Hang Wang
Publication date: 01-12-2021
Publisher: BioMed Central
Keywords: Prostate Cancer
Prostate Cancer
Prostatectomy
Prostatectomy
Published in: BMC Urology / Issue 1/2021
Electronic ISSN: 1471-2490
DOI: https://doi.org/10.1186/s12894-021-00943-z

At a glance: The STEP trials

Springer Medicine

Denonvilliers’ fascia acts as the fulcrum and hammock for continence after radical prostatectomy

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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