Veil Nerve-Sparing Technique and Postoperative Urinary Continence in Open Antegrade Radical Prostatectomy

Purpose: To introduce and evaluate our open antegrade radical prostatectomy (ARP) technique, a nerve-sparing technique which offers patients better postsurgical urinary continence by our technique of 'Veil of Aphrodite'. Methods: Ninety consecutive bilateral nerve-sparing ARPs performed using the Veil technique (intrafascial dissection) were compared to control ARP cases using non-or unilateral nerve sparing. Correlation of urinary continence with immunohistochemical (IHC) stains of nerves (S-100) around the prostate capsule was investigated in 20 consecutive patients whose ARPs were performed by a single surgeon. Results: Fifty-one cases (56.7%) had no urinary incontinence and 72 cases (80.0%) had no or only minor urinary leakage (less than 5% in total a day), and these were significantly higher than in the control group (p = 0.000 and 0.003, respectively) without compromising the surgical margins. S-100 IHC stains significantly correlated nerve sparing (bilateral sparing vs. nonsparing, p = 0.0398), urinary continence (no urinary continence vs. more than 5% in total urine volume a day, p = 0.0489), and early removal of catheter (within a week vs. over a week, p = 0.0041). Conclusions: Open nerve-sparing ARP using the Veil technique may offer better urinary continence postoperatively and this may be supported by S-100 IHC results. This method may be adaptable in any surgical institution. Copyright (C) 2012 S. Karger AG, Basel