Laparoscopy Posterior Reconstruction of the Rhabdosphincter Allows a Rapid Recovery of Continence after Transperitoneal Videolaparoscopic Radical Prostatectomy Bernardo Rocco a , Andrea Gregori b , Silvio Stener b , Luigi Santoro c , Andrea Bozzola b , Stefano Galli b , Roberto Knez b , Francesco Scieri b , Alessandra Scaburri d , Franco Gaboardi b, * a Division of Urology, European Institute of Oncology, Milan, Italy b Department of Urologic Surgery, ‘‘Luigi Sacco’’ University Medical Center, Milan, Italy c Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy d Environmental and Cancer Registry Unit, Istituto Nazionale dei Tumori, Milan, Italy european urology 51 (2007) 996–1003 available at www.sciencedirect.com journal homepage: www.europeanurology.com Article info Article history: Accepted October 5, 2006 Published online ahead of print on October 23, 2006 Keywords: Continence Laparoscopy Prostate cancer Abstract Objectives: Urinary incontinence is one of the major drawbacks of radical retropubic prostatectomy (RRP). One of the possible reasons for this urinary incontinence is a postoperative deficiency of the rhabdosphinc- ter (RS). It has been recently demonstrated that reconstruction of the posterior aspects of the RS allows a rapid recovery of continence after RRP. This study evaluated the application of this technique in videola- paroscopic radical prostatectomy (VLRP), assessing the percentage of continent patients at 3, 30, and 90 d after catheter removal. Methods: A two-arm prospective comparative trial was carried out with 31 patients recruited for each arm. Group A underwent standard VLRP and group B underwent VLRP with RS reconstruction (VLRP-R). Conti- nence was defined as no pads or one diaper/24 h and was assessed 3, 30, and 90 d after the procedure. Results: At catheter removal, 74.2% versus 25% ( p = 0.0004) of patients were continent with the VLRP-R technique versus VLRP, respectively. A statistically significant difference was present at 30 d (83.8% vs. 32.3%; p = 0.0001) At 90 d the difference, although still present, was not statis- tically significant (92.3% vs. 76.9%; p = 0.25). Conclusions: In this preliminary report, the posterior reconstruction of the RS appears to be an easy and feasible technique even in a laparo- scopic setting. Time to continence recovery was significantly shortened. # 2006 European Association of Urology. Published by Elsevier B.V. All rights reserved. * Corresponding author. U.O. Urologia, Ospedale Sacco, Via Grassi, 74, Milan, Italy. Tel. +39 02 39 04 35 45; Fax: +39 02 39 04 35 45. E-mail address: fgaboar@tin.it (F. Gaboardi). 0302-2838/$ – see back matter # 2006 European Association of Urology. Published by Elsevier B.V. All rights reserved. doi:10.1016/j.eururo.2006.10.014