Our patient’s foremost concern about their recovery following prostate cancer treatment 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 in this. However, a decisive factor in preserving continence is dissecting the urethra in a way that preserves the full functional length of the sphincter and reconstructs its proper anatomic fixation within the pelvic floor. With this in mind, we have developed the full functional-length urethra (FFLU) technique at the Martini-Klinik, which makes it possible to fully preserve the function of the urethral sphincter. We apply this surgical technique in both surgical methods – in conventional open surgery as well as in robotic-assisted surgery using the da Vinci system. There is no statistical difference between the two surgical techniques in terms of the continence rate.
There is still the issue of potency. If we define potency using the question of whether or not a patient can have sexual intercourse, the majority of our patients whose nerves on either side of the prostate were spared during surgery can answer in the affirmative.
The table shows the current potency rates for more than 10,000 of our patients whose pre-operative potency was preserved as both nerve bundles were spared. You should treat these outcomes as a guide. Our statistical analysis showed no significant difference in outcomes between different surgical techniques for patients under 59 years old. There was a slight discrepancy in favour of robotic-assisted surgery in older patients.