Incontinence is the most feared side-effect which can occur after the surgical removal of a prostate cancer tumor. In order to avoid this we have developed the FFLU operation technique (Full-Functional-Length-Uretha), which can fully preserve the complete functionality of the urethral sphincter muscle.
A distinct feature of prostate cancer surgery is that the approximately chestnut-sized prostate is completely enclosed by important functional tissue. The prostate is directly connected with the urinary bladder and the urethral sphincter muscle. Additionally, it is enveloped in a fine neural network which controls erections. It is essential that these structures are spared in the event of the surgical removal of the prostate in order to prevent serious side-effects.
We have developed a surgical method at the Martini-Klinik with the aid of which it is possible to successfully preserve the entire functional length of the urethral sphincter as well as the complete anatomic inclusion of the sphincter muscle in the pelvic floor. The introduction of this new operation technique generated a significant improvement of early continence.
The surgical modifications are the result of anatomic studies which have proven that a substantial part of the urethral sphincter is located in the prostate. This part can individually vary between 10 and 40 % of the functional muscle length.
With the new operation technique the urethra is prepared in a manner that the sphincter muscle is completely spared and its anatomically perfect location is reconstructed in the operation. The majority of the patients regain full control of their bladders shortly after the operation.
Already during the first weeks after surgery some patients have good urinary continence. After 3 months 2/3 of our patients reach a nearly perfect continence already. For some patients, the regain of urinary control may take longer than 3 months. This also depends on the individual risk factors involved, e.g. the size of the prostate prior to operation, previous operation on the prostate, age and accompanying illness.