Furthermore, the strategy is associated with “increased patient satisfaction without compromising resection margins,” the investigators report in their paper released online September 26 by the Journal of Urology.
Dr. Joanne N. Nyarangi-Dix and colleagues at the University of Heidelberg point out that for prostate cancer patients undergoing radical prostatectomy, functional outcomes and quality of life are now widely considered to be just as important as cancer control.
Bladder neck preservation during radical prostatectomy is believed to improve urinary continence, but most studies on this subject have been nonrandomized and retrospective, the authors explain.
They therefore conducted a prospective, randomized study involving 208 men presenting for radical prostatectomy (RP) at their institution. The study was single-blinded, i.e., the patients did not know if they had the complete bladder neck preservation (cBNP) procedure or not.
All the patients completed 12 months of follow-up. After excluding 9 subjects, the analysis included 95 men who were assigned to cBNP and 104 controls who were not (non-BNP).
Surgical margin positivity rates were not significantly different between the two groups at 14.7% and 12.5% (p=0.13), the team found.
Mean urine loss, measured by 24-hour pad test, was significantly lower at 3 months postop in the cBNP group than the non-BNP group, at 15.6g versus 49.6g (p
Rates of social continence – defined as use of no more than 1 pad per day – were 84.2% versus 55.3% (p
These differences were reflected in quality-of-life scores. At 3 months, the QOL score was 90.3 in the cBNP group versus 80.4 in the non-BNP group (p
They conclude, “cBNP is associated with significantly higher early and overall continence rates and better QOL-outcomes, without compromising cancer resection. Consequently, we recommend translation of these findings into routine practice: whenever possible cBNP is a goal to be strived for during RP.