Technical Innovations to Optimize Early Return of Urinary Continence

Radical prostatectomy remains the primary approach for the treatment of local and locally advanced prostate cancer. Nevertheless, patients often experience urinary incontinence and erectile dysfunction, affecting their overall quality of life. Understanding the importance of the anatomic relationship between the prostate and the nerves, muscles, fascia, and ligaments surrounding it, as well as the significance of the angulation of the bladder neck and the length of the membranous urethra, is crucial for achieving better outcomes and earlier functional recovery. This chapter focuses on the technical innovations to enhance urinary continence outcomes, which are divided into two sections: preservation of periprostatic structures and total anatomic reconstruction.