Impact of unilateral interposition sural nerve grafting on recovery of urinary function after radical prostatectomy Journal Article

  

Authors:	Singh, H.; Karakiewicz, P.; Shariat, S. F.; Canto, E. I.; Nath, R. K.; Kattan, M. W.; Slawin, K. M.
Article Title:	Impact of unilateral interposition sural nerve grafting on recovery of urinary function after radical prostatectomy
Abstract:	Objectives. To test the hypothesis that unilateral sural nerve graft (SNG) interposition may improve the rate of urinary function (UF) recovery after radical retropubic prostatectomy (RRP) in patients undergoing unilateral nerve resection (UNR). Methods. We studied I I I consecutive patients who underwent RRP with purposeful UNR performed by a single surgeon. Of the I I I patients, 53 underwent unilateral SNG interposition. All patients were invited to complete a questionnaire that included the validated University of California, Los Angeles, Prostate Cancer Index. The time to UF recovery above the median value of the group and urinary control status were evaluated. Results. The median follow-up was 26 and 12 months for the UNR and UNR+SNG patients, respectively. At 12 months after RRP, 94.7% of patients with UNR+SNG reported having complete urinary control or leakage of only a few drops of urine compared with 58.3% of patients with UNR alone (P = 0.012). In multivariate Cox regression models, UNR+SNG was associated with a 9.95 times greater rate of reaching a UF score above the median versus UNR alone (P < 0.001). In multivariate logistic regression analyses, SNG status increased the odds of having complete urinary control or leakage of only a few drops of urine by 14.99 and 29.19 at 6 and 12 months after RRP, respectively (both P < 0.05). Conclusions. In patients undergoing UNR surgery, SNG interposition is associated with a greater rate of UF recovery and a higher likelihood of urinary control after RRP. These findings need to be validated in larger, multicenter, prospective, randomized studies. (C) 2004 Elsevier Inc.
Keywords:	continence; retropubic prostatectomy; incontinence
Journal Title:	Urology
Volume:	63
Issue:	6
ISSN:	0090-4295
Publisher:	Elsevier Science, Inc.
Date Published:	2004-06-01
Start Page:	1122
End Page:	1127
Language:	English
ACCESSION:	WOS:000222000400029
DOI:	10.1016/j.urology.2004.01.016
PROVIDER:	wos
PUBMED:	15183964
Notes:	Article -- Source: Wos

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