Nerve-sparing surgical technique increases continence levels post prostate surgery

The authors determined how nerve-sparing surgical techniques can improve long-term continence levels after prostate surgery. 

Prostate surgery is a common treatment in prostate cancer that involves surgically removing the prostate gland. Different surgical techniques can be used during surgery with different outcomes. Nerve-sparing prostate surgery involves surgically removing the prostate gland while protecting the nerve bundles (sites that allow for feeling and control in the prostate) located on either side of the prostate. Only patients with early stage cancer, cancer confined to the prostate gland and cancer that is far away from the nerve bundles are eligible for this treatment. The aim of this treatment is to remove the cancer with minimal damage to sexual functioning and patient continence (control of bladder function). 

The aim of this study was to determine the benefit of nerve-sparing surgery on long-term continence.

12,533 patients were used in this study. Patients were split into 3 groups. Group 1 (11,204 patients) underwent nerve-sparing surgery. Group 2 (1,128 patients) underwent non-nerve sparing surgery (nerve bundles were removed, involves a different surgical technique than group 1). Group 3 (201 patients) underwent initial nerve-sparing surgery but had to have their nerve bundles removed.

In group 1 the continence rates at week 1 were 59.8%, at 3 months were 76.2% and at 12 months were 85.4%. In group 2 the continence rates at week 1 were 29.1%, at 3 months were 52.8% and at 12 months were 70.5%. In group 3 the continence rates at week 1 were 39.5%, at 3 months were 59.5% and at 12 months were 87%.

Continence rates were significantly higher for group 1 at 1 week and 3 months after surgery compared to those of group 3. Continence rates at 12 months were comparable between group 1 and group 3.

Group 3 had a significantly higher continence rate at 1 week and at 12 months compared to group 2. Group 2 had the lowest rate of continence at 12 months following surgery. Patients in group 2 were 57% less likely to be continent at 12 months than were patients in group 3.

The authors concluded that the nerve-sparing surgical technique increased long-term continence levels. The authors also concluded that the surgical technique may have benefited continence levels, rather than preservation of the nerve bundles themselves. 

If you are considering nerve-sparing prostate surgery, please consult your doctor for potential benefits and risks.