In September I performed 19 operations including 13 dvPs.

One simple prostatectomy was combined with a left inguinal hernia repair. This was the first time I had performed this combination, although I have performed close to 50 hernia repairs at the time of dvP.

The new thing to report is an improvement in continence that I have seen after adding a few sets of sutures to re-construct the pelvic anatomy after removal of the prostate and before the connection is made. I had been doing part of this since I read a paper from Rocco describing his procedure of repairing anatomy behind the connection of the bladder to the urethra. This addition has helped more men achieve quicker urinary control in my experience.

Dr. Tewari has added an additional technique to reconnect the anatomy in front of the connection site.

I have added some of my own modification and have seen a nice short term improvement in urinary control. The best part is that the cancer control has not been compromised in these patients and my positive margin rate has declined.