Why do men experience some degree of incontinence immediately after prostate surgery?
Before surgery men have three layers holding back urine – the internal sphincter muscle, the prostate lobes and an external sphincter muscle. After surgery, there is only one layer – the external sphincter. Removing the prostate disturbs the area between the bladder and urethra, which carries urine out of the body. During surgery, the bladder is pulled down to join the urethra and in so doing, restoring continuity. After surgery , it is mainly the external urethral sphincter alone that is responsible for maintaining continence. In the first few days after surgery, this sphincter muscle is sometimes not strong enough to ensure full continence. The Rocco stitch is specially designed to help reconstruct the join between the bladder and the urethra. This is an extra stitch that is not usually used. It reconstructs a muscle layer called the rectoreuthralis. It is not well understood how it works but it appears to pull out the sphincter complex from the pelvic floor changing the angle of the
