Rectus fascial sling suspension of the vesicourethral anastomosis after radical prostatectomy

Purpose: A study was performed to ascertain if fascial sling suspension of the anastomosis after radical retropubic prostatectomy would enhance postoperative continence rates. Materials and Methods: A fascial sling suspension with a strip harvested from the fascia of the rectus muscle was performed at the time of radical retropubic prostatectomy in 30 patients (group 2). Postoperative continence was compared to that of 30 previous patients (group 1) operated on by the same surgeon. Results: Complete continence rates (no protection needed at any time) were 18 of 30 men (60%) in group 2 and 10 of 30 (33%) in group 1 (p = 0.069) at 1 month, 28 of 30 men (93%) in group 2 and 21 of 30 (70%) in group 1 (p = 0.042) at 3 months, 30 of 30 in group 2 (100%) and 27 of 30 (90%) in group 1 at 6 months, and 30 of 30 in group 2 (100%) and 28 of 30 (93%) in group 1 at 9 and 12 months. Conclusions: Fascial sling suspension resulted in an earlier return and more complete recovery of urinary continence in men undergoing radical prostatectomy.