This was done by vas deferens urethral suspension (VDUS) in a prospective randomized design. The investigators anticipated a 90% power to detect the difference between the currently observed 70% early involuntary urine loss and possibly 35% (odds ratio of 0.231) with VDUS using a sample size in each group of 47 patients. Men with normal preoperative urine continence and no prior TURP were included. All men reported ICIQ-short form questionnaires and a 24 hour home pad test result at 1, 3, 7, 14, 30, 90, and 180 days postoperatively.
They found no difference in anastomotic leakage by cystogram performed 10 postoperatively. In the control group, one patient developed an anastomotic stricture 3 months postoperatively. Regarding the early return of urinary continence, at one week after Foley catheter removal, 35% of VDUS group patients vs. 14% of control patients were free of urinary incontinence. At 12 weeks 62% vs. 41% respectively in the VDUS vs. control group were free of urine incontinence. This difference disappeared after longer follow-up. Twenty-four hours pad tests showed a trend toward reduced urine loss in the VDUS arm, but the difference was not statistically significant. QOL questionnaires confirmed early improvement in urine continence.
Presented by Henk G. van der Poel MD, PhD, et al. at the 26th Annual European Association of Urology (EAU) Congress - March 18 - 21, 2011 - Austria Centre Vienna, Vienna, Austria