Early experience with walsh technique of radical retropubic prostatectomy

Fowler, Jackson E.; Clayton, Michael; Sharifi, R.; Mouli, K.; Ojeda, Larry; Ray, Paul S.

doi:10.1016/0090-4295(87)90061-6

Cited by 27 publications

(10 citation statements)

References 11 publications

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“…The potency rate preserved after conventional radical cystectomy and rad ical prostatectomy has been reported to be 0-28.6% [2,3,5,6,14,15], which is consistent with our result of 14.3% (3/21), whereas potency rates after simple cystec tomy are 70% according to Romanus [2] and 100% according to us. No potency was observed after conven tional radical cystectomy and simultaneous urethrcctomy in our study although Schover et al [5] and Finklc and Williams [16] demonstrated a few cases of potency after urethrectomy, in which the cavernous nerves may have barely escaped injury during operation.…”

Section: Discussionsupporting

confidence: 82%

“…On the other hand, by the nerve-sparing technique, potency was maintained in 82% by Walsh and Most win [8] and 85% by Fowler et al [14], although one of the cases reported by Walsh and Mostwin [8] who received simultaneous urethrectomy suffered from impotency af ter surgery. Additionally, recovery time was only 1-6 months after the nerve-sparing technique, while about 1 year has been reported to be required for regaining potency after using a conventional technique [8].…”

Section: Discussionmentioning

confidence: 98%

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Urethrectomy Is Harmful for Preserving Potency after Radical Cystectomy

Kitamura¹,

Moriyama²,

Shibamoto³

et al. 1987

Urol Int

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Twenty-three patients who underwent conventional total cystectomy were examined regarding postoperative potency. Two patients who were subjected to simple cystectomy and whose partial prostate and whole seminal vesicles were left showed full erection and normal ejaculation 1–2 months after surgery, thus giving 100% potency after simple cystectomy. In contrast, of 12 patients who underwent radical cystectomy alone, only 3 (25%) regained potency postoperatively, and the strength and duration of erection were not satisfactory for 1 of the 3 patients. Nine patients who received radical cystectomy and urethrectomy did not show signs of potency postoperatively. The sum total postoperative potency rate in the 21 patients subjected to radical cystectomy was 14.3% (3/21). The facts may indicate that urethrectomy is harmful for postoperative potency because damage of the cavernous nerves probably takes place during surgery. To avoid nerve damage, the urethra should be left intact during radical cystectomy employing the nerve-sparing technique developed by Walsh and Donker unless the posterior urethra is invaded by bladder carcinoma. In addition, it was demonstrated that pelvic irradiation might cause impotency as neither pelvic lymph node dissection nor cisplatin administration had any influence on postoperative potency.

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Section: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 98%

Urethrectomy Is Harmful for Preserving Potency after Radical Cystectomy

Kitamura¹,

Moriyama²,

Shibamoto³

et al. 1987

Urol Int

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“…The incidence of continence achieved in the present trial (97% of the total patient population without any instance of total incontinence) is in the range of the reported rates between 67 and 96%, with 0–35% of the patients demonstrating stress incontinence and 0–18% complaining of total incontinence in the literature [10, 12, 13, 14, 15, 16, 17, 18, 19]. The discrepancy between these rates might in part reflect differences in study design, patient population length and completeness of follow-up, methods for measuring incontinence, surgical proficiency and interviewers.…”

Section: Discussionmentioning

confidence: 76%

“…The innervation of this sphincter arises from either the pudendal nerves or the autonomic nerves in the pelvic plexus. Since it has previously been postulated that a nerve-sparing radical prostatectomy technique results in an increase in functional urethral length and maximum urethral closure pressure that reduce the incidence of postoperative incontinence [5, 15], it is logical to expect that the incontinence rate can be higher in those patients in whom both neuromuscular bundles are affected. In previous reports the incidence of urinary incontinence was statistically not different in subjects who had both neuromuscular bundles preserved, one bundle preserved or both bundles excised [4, 17, 18].…”

Section: Discussionmentioning

confidence: 99%

Changes of Urodynamic Findings after Radical Retropubic Prostatectomy

et al. 1999

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“…Fowler et al [18] and O'Donnell and Finan [19] showed that the nerve-sparing radical prostatectomy reduces the risk of incontinence. Steiner et al [3] and Rossignol et al [15] however contradicted this finding.…”

Section: Discussionmentioning

confidence: 99%

Prediction of Urinary Continence following Radical Prostatectomy

et al. 1998

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The aim of this study was to assess the incidence of incontinence after radical prostatectomy and to identify the various factors that can predict urinary continence after radical prostatectomy. Urinary continence following a radical prostatectomy was evaluated in 175 consecutive patients who underwent surgery. Immediately after catheter withdrawal, on the 15th postoperative day, 66% of the patients were incontinent. Varying degrees of incontinence persisted in 53% of the cohort at 1 month postoperatively. Thirty-three, 12, 8 and 2% of the patients remained incontinent at respectively 3, 6, 9 and 12 months of follow-up. A number of possible pre- and peroperative factors which might predict the continence status were examined and related to it at subsequent intervals after the surgical intervention. Preservation of the neurovascular bundles, prior transurethral resection of the prostate, preoperative micturition disorders and age were significant contributors in the prediction of urinary incontinence after radical prostatectomy.

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Early experience with walsh technique of radical retropubic prostatectomy

Cited by 27 publications

References 11 publications

Urethrectomy Is Harmful for Preserving Potency after Radical Cystectomy

Urethrectomy Is Harmful for Preserving Potency after Radical Cystectomy

Changes of Urodynamic Findings after Radical Retropubic Prostatectomy

Prediction of Urinary Continence following Radical Prostatectomy

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