Abstract

  We retrospectively analyzed 103 consecutive patients who underwent robot-assisted radical prostatectomy (RARP) with bilateral or unilateral endopelvic fascia preservation (pEPF) and intrafascial or interfascial nerve-sparing (INS). Based on the content of the operative video and pathological assessment of the specimen of the prostatic base immunohistochemically stained using S-100 antibody, the patients were divided into three groups : bilateral pEPF and INS HG group, n＝49), bilateral pEPF and unilateral INS (MG group, n＝37), and unilateral pEPF and INS (LG group, n＝17). At 1 month after surgery the pad-free urinary continence rates of the HG (46.9％) and MG (29.7％) groups were significantly higher than that of the LG (0％) group (p＜0.001 : HG vs. LG group, p＝0.012 : MG vs. LG group). At 3 months the HG (62.5％) group showed a significantly higher rate of pad-free urinary continence than the LG (29.4％) group (p＝0.035). Based on multivariate analysis, LG was the only significant prognostic indicator of delayed continence recovery at 1 month after surgery. The surgical procedures intended for bilateral pEPF and the performing of bilateral INS during RARP were considered to be effective for early continence recovery.