A new technique for reconstruction of the bladder neck during Radical Prostatectomy

Bernardino De Concilio1, Gaetano Chiapparrone 2, Guglielmo Zeccolini1, Antonio Celia1
  • 1 Ospedale San Bassiano, S.C. Urologia (Bassano del grappa)
  • 2 Ospedale di Cattinara, S.C. Urologia (Trieste)


The technique used for the bladder neck reconstruction during robotic assisted radical prostatectomy (RALP), can influence the continence rate. In this video we present a new technique we have adopted for the reconstruction of the bladder neck: this procedure belongs from gastrointestinal surgery and it is used to close bowel anastomosis according to the technique described by Gambee or O’ Conell. This technique consists in a single-layer through-and-through anastomosis: the suture goes from serous to mucosal surface, back into the mucosa on the same side of the incision, out into the middle of the cut surface to be approximated, across the incision into the wound edge opposite, down into gut lumen, back through the mucosa and through the wall to the serous surface and a tie with the tail of the suture across the incision. This technique allows to create a bladder neck more similar to the native one if compared with the anterior tennis racket technique and may lead to improved functional outcomes. An improved and more accurate reconstruction of the bladder neck may lead to more favourable functional outcome, this particular technique has never been utilized before to reconstruct the bladder neck. Urologists should consider to adopt it to increase the early continence rate.