Anatomic restoration technique of continence mechanism and preservation of puboprostatic collar: a novel modification to achieve early urinary continence in men undergoing robotic prostatectomy.

Objectives: The puboprostatic ligaments, puboperinealis muscle, and arcus tendineus are all recognized as important for continence in men and women. This complex of ligaments, muscles, and tendineus aponeurosis acts in unison to provide continence and can be disrupted during robotic prostatectomy. We propose that preservation of the puboprostatic collar during robotic surgery will help to restore early continence in men undergoing robotic prostatectomy.

Preservation of the puboprostatic collar and puboperineoplasty for early recovery of urinary continence after robotic prostatectomy: anatomic basis and preliminary outcomes.

Objectives: The aims of the present study are to prove the hypothesis that the preservation of the puboprostatic collar and puboperineoplasty contribute to the early recovery of urinary continence after robotic radical prostatectomy. We reconfirm the anatomy of the periurethral supporting tissue and show the preliminary result on the early continence of patients undergoing this modification.

Methods: Using 10, male, fresh cadavers, we traced the endopelvic fascia, the fascia of levator ani, puboprostatic ligaments, rhabdosphincter, and puboperinealis muscle to devise strategies in preserving this complex.