Pioneering new technique improves patient outcomes

For patients diagnosed with prostate cancer, undergoing a prostatectomy, surgery to remove the prostate gland, brings the unpleasant side effect of post-operative urinary incontinence. While urinary incontinence is usually a temporary problem, most patients require at least three months to fully recover their continence.

That’s what prompted Professor Greg Shaw, Consultant Urologist at The Prostate Centre, part of HCA Healthcare UK, and Mr Jeremy Ockrim, a specialist in urinary incontinence, to develop a new surgical technique known as ‘complete urethral preservation’ or CUP.

Featured in the British Journal of Urology (BJU) in August 2024, this pioneering technique allows the surgeon to remove the prostate gland while keeping as much length as possible of the urethra. The advantage this offers patients is faster recovery from the urine leakage which commonly occurs after prostate removal. It means patients who are particularly concerned about recovering from urinary incontinence will be able to quickly return to normal activities, like work and exercise, without the need to wear pads.

In fact, points out Professor Shaw, “most patients undergoing this technique won’t experience any urine leakage at all during their recovery.” As one patient, Des, put it, “this was the biggest surprise. Just four weeks after my prostate removal, I was well on the way to recovery, with absolutely no urinary incontinence from the outset.”

Professor Shaw is currently training colleagues and clinicians in how to perform the technique and integrate it into robotic radical prostatectomy for patients with prostate cancer that has not spread. The published paper includes an instructional video for surgeons hoping to adopt the technique.

Consultant surgeon, Mr Tarek Al-Hammouri, who was trained on the technique by Professor Shaw commented on what a difference it has made for his patients:

“I had the privilege of learning the CUP technique from Professor Shaw, and it has notably improved my patients' recovery and quality of life. I would encourage my fellow surgeons to explore this technique to help their patients recover urinary continence more quickly following robotic radical prostatectomy. It really does offer significant benefits to patients.”

Another patient, Ron, described his post-surgery results and recovery as “startlingly good” after his prostatectomy including CUP surgery with Professor Shaw. 

“I have experienced full bladder control from the moment the catheter was removed,” he said, “which was not what I was expecting at all. Worry about urinary incontinence was probably my main concern before the operation, and I am absolutely delighted to be able to live my life as normal.” 

Commenting on CUP, Ron described it as “a wonderful technique, which I would recommend to any man for whom it is suitable.”

Describing his recovery from surgery using the CUP technique, another patient, Samson, also reported that urinary incontinence simply wasn’t an issue. He said, “honestly, apart from using incontinent pad as a precaution, I experienced no leak at all, and I stopped using incontinence pads after three weeks. Indeed, I am very lucky.”

To find out more about CUP or to contact Professor Shaw, visit The Prostate Centre or call 020 3993 5502.