Volume 51, Issue 4, Pages (April 2007)

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Volume 51, Issue 4, Pages 996-1003 (April 2007) Posterior Reconstruction of the Rhabdosphincter Allows a Rapid Recovery of Continence after Transperitoneal Videolaparoscopic Radical Prostatectomy Bernardo Rocco, Andrea Gregori, Silvio Stener, Luigi Santoro, Andrea Bozzola, Stefano Galli, Roberto Knez, Francesco Scieri, Alessandra Scaburri, Franco Gaboardi European Urology Volume 51, Issue 4, Pages 996-1003 (April 2007) DOI: 10.1016/j.eururo.2006.10.014 Copyright © 2006 European Association of Urology Terms and Conditions

Figs. 1–2 Placement of the first suture for the posterior reconstruction of the rhabdosphincter. It can be seen clearly that the suture does not involve the posterior portion of the urethra. C=catheter; LA=levator ani; NVB=neurovascular bundle; PF=prostatic fascia; RS=rhabdosphincter; U=urethra. European Urology 2007 51, 996-1003DOI: (10.1016/j.eururo.2006.10.014) Copyright © 2006 European Association of Urology Terms and Conditions

Fig. 3 The suture is then passed through the remaining part of the Denonvilliers fascia. B=bladder; DF=Denonvilliers fascia LA=levator ani; PF=prostatic fascia. European Urology 2007 51, 996-1003DOI: (10.1016/j.eururo.2006.10.014) Copyright © 2006 European Association of Urology Terms and Conditions

Fig. 4 The musculofascial plate is reconstructed by joining the posterior median raphe with the connected dorsal wall of the RS to the residuum of Denonvilliers fascia. As can be seen, the urethra is not involved in this suture. Panoramic view. B=bladder; C=catheter; DF=Denonvilliers fascia; LA=levator ani; NVB=neurovascular bundles; PF=prostatic fascia; RS=rhabdosphincter; SP=Santorini plexus; U=urethra. European Urology 2007 51, 996-1003DOI: (10.1016/j.eururo.2006.10.014) Copyright © 2006 European Association of Urology Terms and Conditions

Fig. 5 The suture is then inserted 1–2cm cranially and posteriorly to the bladder neck (white circle) and is then tightened, completing the reconstruction. BN=bladder neck (white circle); C=catheter; DF=Denonvilliers fascia; LA=levator ani; PF=prostatic fascia. European Urology 2007 51, 996-1003DOI: (10.1016/j.eururo.2006.10.014) Copyright © 2006 European Association of Urology Terms and Conditions