Bladder Neck Dissection During Robotic Radical Prostatectomy

  • Thierry PiechaudEmail author
  • Filippo Annino


The approach to the bladder neck (BN) is the first critical step of antegrade laparoscopic radical prostatectomy. Its identification can be difficult in some cases, and a mistake at this point of the surgery can compromise the rest of the operation, influencing the next steps of dissection as well as the anastomosis.


  1. 1.
    Poore RE, McCullough DL, Jarow JP. Puboprostatic ligament sparing improves urinary continence after radical retropubic prostatectomy. Urology. 1998;51:67–72.CrossRefPubMedGoogle Scholar
  2. 2.
    Ahlering TE, Eichel L, Edwards RA, Lee DI, Skarecky DW. Robotic radical prostatectomy: a technique to reduce pT2 positive margins. Urology. 2004;64:1224–8.CrossRefPubMedGoogle Scholar
  3. 3.
    Deliveliotis C, Protogerou V, Alargof E, Varkarakis J. Radical prostatectomy: bladder neck preservation and puboprostatic ligament sparing: effects on continence and positive margins. Urology. 2002;60:855–8.CrossRefPubMedGoogle Scholar
  4. 4.
    Katz R, Salomon L, Hoznek A, de la Taille A, Antiphon P, Abbou CC. Positive surgical margins in laparoscopic radical prostatectomy: the impact of apical dissection, bladder neck remodelling and nerve preservation. J Urol. 2003;169:2049–52.CrossRefPubMedGoogle Scholar
  5. 5.
    Walsh PC, Retik AB, Darracott Vaughan E, Wein AJ. Campbell’s urology. 8th ed. St. Louis: Elesevier; 2003. Chap. 2.Google Scholar
  6. 6.
    Secin FP, Karanikolas N, Gopalan A, Bianco FJ, Shayegan B, Touijer K, Olgac S, Myers RP, Dalbagni G, Guillonneau B. The anterior layer of Denonvilliers’ fascia: a common misconception in the laparoscopic prostatectomy literature. J Urol. 2007;177:521–5.CrossRefPubMedGoogle Scholar
  7. 7.
    Stolzenburg JU, Schwalenberg T, Horn LC, Neuhaus J, Constantinides C, Liatsikos EN. Anatomical landmarks of radical prostatectomy. Eur Urol. 2007;51:629–39.CrossRefPubMedGoogle Scholar
  8. 8.
    Wimpissinger TF, Tschabitscher M, Feichtinger H, Stackl W. Surgical anatomy of the puboprostatic complex with special reference to radical perineal prostatectomy. BJU Int. 2003;92:681–4.CrossRefPubMedGoogle Scholar
  9. 9.
    Young HH. The cure of cancer of the prostate by radical perineal prostatectomy (prostato-seminal vesiculectomy): history, literature and statistics of Young’s operation. J Urol. 1945;53:188–256.CrossRefGoogle Scholar
  10. 10.
    Steiner MS. The puboprostatic ligament and the male urethral suspensory mechanism: an anatomic study. Urology. 1994;44:530–4.CrossRefPubMedGoogle Scholar
  11. 11.
    Albers DD, Faulkner KK, Cheatham WN, Elledge EF, Coalson RE. Surgical anatomy of the pubovesical (puboprostatic) ligaments. J Urol. 1973;109:388–92.CrossRefPubMedGoogle Scholar
  12. 12.
    Myers RP. Detrusor apron, associated vascular plexus, and avascular plane: relevance to radical retropubic prostatectomy – anatomic and surgical commentary. Urology. 2002;59:472–9.CrossRefPubMedGoogle Scholar
  13. 13.
    Rassweiler J, Schulze M, Teber D, Seemann O, Frede T. Laparoscopic radical prostatectomy: functional and oncological outcomes. Curr Opin Urol. 2004;14:75–82.CrossRefPubMedGoogle Scholar
  14. 14.
    Young HH. The radical cure of cancer of the prostate. Surg Gynecol Obstet. 1937;64:472–84.Google Scholar
  15. 15.
    Presti JC Jr, Schmidt RA, Narayan PA, Carroll PR, Tanagho EA. Pathophysiology of urinary incontinence after radical prostatectomy. J Urol. 1990;143:975–8.CrossRefPubMedGoogle Scholar
  16. 16.
    Hoznek A, Antiphon P, Borkowski T, Gettman MT, Katz R, Salomon L, et al. Assessment of surgical technique and perioperative morbidity associated with extraperitoneal versus transperitoneal laparoscopic radical prostatectomy. Urology. 2003;61:617–22.CrossRefPubMedGoogle Scholar
  17. 17.
    Rassweiler J, Sentker L, Seemann O, Hatzinger M, Rumpelt HJ. Laparoscopic radical prostatectomy with the Heilbronn technique: an analysis of the first 180 cases. J Urol. 2001;166:2101–8.CrossRefPubMedGoogle Scholar
  18. 18.
    Stolzenburg JU, Liatsikos EN, Rabenalt R, Do M, Sakelaropoulos G, Horn LC, Truss MC. Nerve sparing endoscopic extraperitoneal radical prostatectomy: effect of puboprostatic ligament preservation on early continence and positive margins. Eur Urol. 2006;49:103–12.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  1. 1.Groupe Urologie Saint AugustinClinique Saint AugustinBordeauxFrance
  2. 2.St. Augustin ClinicBordeauxFrance

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