Facts about post-prostatectomy continence and potency

Continence

Our patients' foremost concern about their recovery following prostate cancer treatment — aside from cure itself — is whether they will remain continent. Naturally, the patient's age, any comorbidities, and the nerve-sparing approach — i.e. on one or both sides of the prostate — all play a role. However, the decisive factor in preserving continence is dissecting the urethra in a way that preserves the sphincter's full functional length and reconstructs its correct anatomic position within the pelvic floor. With this in mind, we developed the Full-Functional-Length Urethra (FFLU) technique at the Martini-Klinik, a specific dissection technique designed to fully preserve the urethral sphincter and its function. We apply this technique in both surgical approaches used at our clinic — conventional open surgery as well as robotic-assisted surgery. In terms of long-term continence rates, there is no statistical difference between the open and robotic-assisted approaches (source: Haese et al. 2019). A difference is more evident in the time to regain continence after surgery and in the patient's age at the time of surgery, as illustrated in the graphic below. Experience shows that older patients need more time to regain continence and have a somewhat lower chance of regaining it as age increases.