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Our Modified Technique of Total Posterior Reconstruction in Open Retropubic Radical Prostatectomy

Aim: We compared the outcome of retropubic radical prostatectomy with or without our modified technique of total posterior reconstruction. The technique differs from the standard technique in the form of reconstruction of retrotrigonal tissue using a detrusor muscular flap. The free end of the flap is sutured to the Denonvillier’s fascia to complete posterior reconstruction. Materials and Methods: From August 2006 to July 2008, 32 patients with localized prostate carcinoma who underwent radical retropubic prostatecto-my were prospectively evaluated in 2 groups operated on by 1 surgeon. The first 22 patients underwent standard technique of radical retropubic prostatectomy and subsequently we used and are now using a modified technique. The first 10 patients operated on by the modified technique are included in the present study. Both groups were compared for postoperative continence. Continence was assessed using quality of life questionnaires. A patient was considered incontinent if he had to change more than 1 pad per 24 h. Results: Continence rates in group 1 were 72.73, 81.82, 86.40 and 95.46% at 1, 3, 6, and 12 months follow-up respectively as opposed to 80, 90, 90, and 100% respectively in group 2 patients. Conclusion: Total posterior reconstruction is an effective way to achieve an early return of continence.