However, the role of bladder neck preservation in maintaining urinary continence is still controversial. Ampullae of the vas deferens are posterior to the bladder neck and are identified on upward traction of the bladder with a malleable retractor. The seminal vesicles are lateral to the ampullae of the vas deferens. The prostatic pedicles are lateral to the seminal vesicles. To avoid any pressure points on the patient.
Stirrups are available that can comfortably position the patient.
Optimally, mild hyperflexion of the lower spine and the pelvis, assisted by a sandbag or rolls to rotate the hip joints outwards. Extreme hyperflexion of the spine should be avoided. DRE during the prostatectomy procedure is crucial. Other regular drapes could be used. The curved Lowsley retractor is placed within the urethra and advanced into the bladder, then blades are opened within the bladder.