Impact of Posterior Tibial Nerve Stimulation on Early Continence Following Extraperitoneal Laparoscopic Radical Prostatectomy With Three Trocars

Aim: Posterior tibial nerve stimulation (PTNS) might stimulate the sacral nerves and lead to work pelvic floor muscles. We evaluated to effects of PTNS on continence results after extraperitoneal laparoscopic radical prostatectomy (eLRP) with three trocars during early post operative period.

Methods: Prospectively recorded data of eLRP with three trocars was retrospectively reviewed for continence results between January 2017 and April 2024. Demographic, clinical, and follow-up data including age, prostate-specific antigen, prostate volume, nerve sparing surgery, and Gleason score were considered for match-paired analysis criteria. Patients were divided into two groups according to whether received PTNS therapy after surgery or not. Group 1 consisted of patients without PTNS (n = 66), and Group 2 consisted of patients who were applied PTNS (n = 66) after eLRP. Continence status, urine loss ratio (ULR), ICIQ-SF, and SF-12 Quality of Life Scale were recorded during outpatient control after 2nd, 3rd, 6th and 12th months of surgery. Statistically significant p was p ≤ 0.05.

Results: Mean follow-up was 25 ± 8.7 months. There were 66 patients in each group and match-paired analyses were performed. Group 2 had significant lower incontinence rate and ICIQ-SF score at second and third months follow-up (p = 0.026 and p = 0.045; p = 0.044 and p = 0.031 respectively). Group 2 had significantly higher Physical Component Summary (PCS) and Mental Component Summary (MCS) (p = 0.005 and p = 0.011 for PCS; p = 0.008 and p = 0.025 for MCS, respectively) at second and third months follow-up. Additionally, ULR was significant better in Group 2 at second and third month of surgery (p = 0.042, p = 0.037, respectively). All these parameters were comparable between groups after sixth and 12th months.

Conclusions: PTNS can be safely applied to provide early continence in patients underwent eLRP. Due to improved functional outcomes, higher quality of life might be gained in early follow-up period.