ORIGINAL RESEARCH article
Front. Surg.
Sec. Genitourinary Surgery and Interventions
Volume 12 - 2025 | doi: 10.3389/fsurg.2025.1645617
This article is part of the Research TopicTechnological Evolution in Minimally-Invasive Radical Prostatectomy. From Laparoscopic to Single-Port Robotically Assisted.View all articles
Study on the Impact of the Reserved Length of the Membranous Urethra During Laparoscopic Radical Prostatectomy on the Recovery of Urinary Control Function in Patients
Provisionally accepted
- Linyi Cancer Hospital, Linyi, China
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Background Prostate cancer is a common malignant tumor in the male urogenital system, and laparoscopic radical prostatectomy (LRP) is the standard surgical procedure for early-stage patients. However, postoperative urinary incontinence remains a major complication. The membranous urethra and its surrounding sphincters play a critical role in urinary continence, but the impact of their preserved length on postoperative recovery of urinary continence function remains unclear. Objective To investigate the effect of the preserved length of the membranous urethra during LRP on early and long-term recovery of urinary continence function in patients. Methods A retrospective analysis was conducted on 160 patients who underwent LRP from March 2023 to June 2024. The patients were divided into a long-segment group (preserved length ≥15 mm, 90 cases) and a short-segment group (preserved length <15 mm, 70 cases) based on the preserved length of the membranous urethra. The International Continence Society criteria were used to evaluate the urinary continence recovery rate (≤1 pad/day) at 1, 3, 12, and 24 months postoperatively, and differences between the two groups were compared. Results Baseline characteristics were comparable between long-segment (≥15 mm, n=90) and short-segment (<15 mm, n=70) groups (P > 0.05). The long-segment group demonstrated significantly superior urinary continence recovery at all time points (P < 0.05): At 1 month, pad-based recovery (38.9% vs. 25.7%) and PGI-I improvement (41.1% vs. 28.6%); at 3 months (61.1% vs. 42.9%; 65.6% vs. 47.1%); at 12 months (77.8% vs. 64.3%; 80.0% vs. 67.1%); and at 24 months (88.9% vs. 78.6%; 91.1% vs. 81.4%). Notably, patients receiving bilateral nerve-sparing with long urethral preservation achieved optimal outcomes (94.3% pad-based recovery; 96.2% PGI-I improvement), significantly surpassing other nerve-sparing approaches (P < 0.05). Conclusion Preserving the length of the membranous urethra ≥15 mm during LRP can significantly promote the recovery of early and long-term urinary continence function, providing a basis for precise surgical operations in clinical practice. Future studies with larger sample sizes and longer follow-up periods are needed for validation.
Keywords: laparoscopic radical prostatectomy, membranous urethra, Urinary continence function, Preserved length, Urinary Incontinence
Received: 12 Jun 2025; Accepted: 28 Aug 2025.
Copyright: © 2025 Li, Lin, Bai and Guo. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Huaiyuan Guo, Linyi Cancer Hospital, Linyi, China
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