was used to divide the posterior and lateral bladder pedicles to the level of the puboprostatic
ligaments and the lateral prostatic pedicles, after the dissection of the endopelvic fascia.
1) Additionally, the small prostate and rudimentary puboprostatic
ligaments (2) can be easily torn with trauma allowing lifting up of the prostate and longer gap between both urethral ends.
1) Because the posterior urethra is fixed at both the urogenital diaphragm and the puboprostatic
ligaments, the bulbomembranous junction is more vulnerable to injury during pelvic fracture.
These include perioperative factors, such as age and prostate volume, (5) and certain anatomic or surgical factors important in continence preservation (injury to the arterial supply and preservation of urethral support mechanisms, including the endopelvic fascia and puboprostatic ligaments).
After cutting the puboprostatic ligament, the deep dorsal vein was suture-ligated and cut without suspending it to the pubic bone and the urethra was exposed.
They analyzed the influence of perioperative factors (body weight, prostate volume, patient age, and pelvic floor exercise), anatomic factors (puboperinealis muscle-sparing dissection, trigonal denervation, and preservation of endopelvic fascia), and technical factors (bladder neck preservation, urethral length preservation, mucosal eversion, neurovascular bundle, and puboprostatic ligament preservation).
The puboprostatic ligaments (PPL) anchor the prostate to the pubis and must be manipulated to successfully remove a cancerous prostate gland.
The puboprostatic ligament and the male urethral suspensory mechanism: An anatomic study.
Puboprostatic ligament sparing improves urinary continence after radical retropubic prostatectomy.
Radical prostatectomy: Bladder neck preservation and puboprostatic ligament sparing--effects on continence and positive margins.
no bladder neck conservation, section of puboprostatic
ligaments, same lymph node dissection).
43] and when both bladder neck-sparing and puboprostatic
ligament-sparing techniques were employed, the incontinence rate at 12 months was 6% compared to 8% for either technique alone.