Impact of total fascia preservation on early recovery of urinary continence after radical prostatectomy

The objective was to investigate the effect of preserving the total fascia surrounding the prostate (lateral pelvic fascia (LPF) and posterior musculofascial plate) on the early return of urinary continence after three-dimensional laparoscopic radical prostatectomy (3D-LRP). Data from 70 consecutive patients who underwent 3D-LRP from April 2015 to February 2017 were collected prospectively and analyzed retrospectively. Patients were categorized into two groups: with or without LPF preservation; each group consisted of 35 consecutive patients. The rates of urinary continence within 12 weeks (no pad and no urinary leakage) were compared between groups using a 24-hour pad test and questionnaires of the Expanded Prostate Cancer Index Composite (EPIC). Immediately after Foley catheter removal, accumulated recovery rates of continence with the Kaplan–Meier method were 65.7% (23/35) and 14.3% (5/35) for LPF preservation and non-preservation groups, respectively. Four weeks after surgery, continence rates increased to 80% (28/35) and 20% (7/35), respectively. A log-rank test showed a statistical difference between groups (p < 0.001). The hazard ratio (HR) was 3.341 (95% confidence interval, 1.772–6.301). Our results demonstrated the effectiveness of total fascia preservation for the early recovery of urinary continence after radical prostatectomy. Level of evidence: Not applicable for this multicenter audit.