Objective: To present the clinical results of 51 patients of clinically localized prostate cancer treated by laparoscopic radical prostatectomy, especially recovery of urinary continence. To analysis how to improve recovery of urinary continence.
Methods: From February 2004 to March 2008, we performed LRP on 51 patients. All patients were diagnosed by pathological result preoperatively. T1a-1b 4 cases (8%), T1c 15 cases (29%), T2a 7 cases (14%), T2b 5 cases (10%), T2c 20 cases (39%).
Results: Forty-nine cases were treated by LRP successfully. There were two cases converted to open surgery. Urine leaking happened in 3 cases, but recovered without intervention. Urinary catheter duration was 14 - 45 days (mean 16 days). Six months and 12 months after LRP, incontinence happened 7/39 cases (17.9%) and 5/20 cases (25%) respectively. Complete incontinence happened in one case. The ratio of incontinence happened in the first 20 cases and the following 31 cases were 6/20 (30%) and 7/31 (22%) respectively. There were two cases had rectal injury. Both cases underwent colostomy. Duration of follow up were from 3 - 53 months (mean 17 months). Two cases recurred. One of them was treated with hormone therapy, the other one died of operation for lung metastasis. Other patients' serum total PSA were less than 0.2 microg/L.
Conclusions: Extraperitoneal laparoscopic radical prostatectomy is efficient and safe approach for localized prostate cancer. The correct handling of pubic prostatic ligaments, external urethral sphincter and neurovascular bundle are important for recovery of urinary continence. And so does the experience of LRP.