The Impact of Tube-Shaped Bladder Neck Modification on Early-Term Continence in Robotic Radical Prostatectomy

Abstract

Objective: We aimed to investigate the effect of tube-shaped bladder neck, which we define as our modified urethral anastomosis technique, on early continence in patients undergoing robot-assisted radical prostatectomy. Methods: This retrospective study (2017-2020) compared standard anastomosis (group 1, n = 75) with a modified technique (group 2, n = 74) in patients undergoing radical prostatectomy. Preoperative, perioperative, postoperative, and histopathological characteristics of the patients were recorded. Continence was assessed using the Turkish version of the International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF), and daily pad usage was recorded. Patients who never used a pad and had an ICIQ-SF score of ≤6 were considered continent. Erectile function was evaluated using the International Index of Erectile Function-5 form. Results: When evaluating postoperative continence status, the number of pads used and the ICIQ-SF score were significantly lower in the group that received the new technique at the first, third, and sixth months. In our study, the postoperative continence rates were 18.7%-36.5% at 1 month, 38.7%-63.5% at 3 months, and 56%-77% at 6 months for groups 1 and 2. Our new technique provided statistically superior results during the first 6 months (P = .015, P = .002, and P = .007, respectively). Conclusion: The modified urethral anastomosis technique accelerates the recovery of early continence (within 1-6 months), while achieving comparable long-term outcomes to those of the standard method. Our new technique is oncologically reliable and does not compromise cancer control. Cite this article as: Aktaş Y, Yılmaz K, Kılıç Ş, et al. The impact of tube-shaped bladder neck modification on early-term continence in robotic radical prostatectomy. Urol Res Pract. 2026;52, doi: 10.5152/tud.2026.26053.