CUP (Complete urethral preservation)

User

Posted 18 Sep 2025 at 07:38

This appears to be another possible advance in prostate surgery.

Basically, at present, the uretha which runs through the prostate, is cut off at both ends when the prostate is removed, then rejoined.

CUP involves dissecting the uthera from the prostate leaving it intact before the gland is removed.

Apparently this will vastly improve incontinence side effects and prevent the loss to penis length associated with the shortening and rejoining of the uretha.

Seems a wonderful development to me. My only concern would be that the dissection might leave behind cancerous prostate cells but apparently this does not occur.

https://www.uclh.nhs.uk/news/new-surgical-technique-preserves-continence-men-after-prostate-removal

I suppose they'll now have to trial the new technique. Hopefully if the results are favourable, it will later be introduced.

It's great to see the surgical advances are keeping up with advances in radiotherapy.

Edited by member 18 Sep 2025 at 15:48 | Reason: Typo

User

Posted 18 Sep 2025 at 07:38

This appears to be another possible advance in prostate surgery.

Basically, at present, the uretha which runs through the prostate, is cut off at both ends when the prostate is removed, then rejoined.

CUP involves dissecting the uthera from the prostate leaving it intact before the gland is removed.

Apparently this will vastly improve incontinence side effects and prevent the loss to penis length associated with the shortening and rejoining of the uretha.

Seems a wonderful development to me. My only concern would be that the dissection might leave behind cancerous prostate cells but apparently this does not occur.

https://www.uclh.nhs.uk/news/new-surgical-technique-preserves-continence-men-after-prostate-removal

I suppose they'll now have to trial the new technique. Hopefully if the results are favourable, it will later be introduced.

It's great to see the surgical advances are keeping up with advances in radiotherapy.

Edited by member 18 Sep 2025 at 15:48 | Reason: Typo

User

Posted 24 Aug 2026 at 23:53

This was NHS in the West Midlands . There’s is not a lot of information about it , nothing in info given out at hospital . I’m going to ask Dr more when we see him in October, pleased whatever he did as it’s really aided my husbands recovery . If anyone would be interested I could report back after. Seems a really good thing

User

Posted 25 Aug 2026 at 14:02

That being the case, the outcome looks similar to Retzius sparing.

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User

Posted 18 Sep 2025 at 18:57

Adrian, interesting article, I wonder what happens to the sphincter.

Thanks Chris

User

Posted 23 Aug 2026 at 22:38

I think my husbands had this but I can’t find much information about it . Does anyone have any info ? Is it currently used a lot ? I’d never heard of it til after his prostatectomy and surgeon said he had used a new technique and my husband has had no post surgery incontinence at all . Any info gratefully received

User

Posted 24 Aug 2026 at 07:28

It seems the process is also known as TULP (Total Length Urethral Preservation)

https://www.sciencedirect.com/science/article/pii/S2590089726000368

It seems it's still being trialed. I'd have thought, a bit like Neurosafe (checks of margins during surgery) and Retzius sparing RARP, that CUP/TULP, due to additional costs, will be more easly available privately than on the NHS?

Edited by member 24 Aug 2026 at 07:35 | Reason: Add link

User

Posted 24 Aug 2026 at 23:53

User

Posted 25 Aug 2026 at 09:50

Would have saved me from the peritonitis, sepsis and 3 weeks in hospital that resulted from my leaking urethra.

User

Posted 25 Aug 2026 at 10:16

A bit of recent research into CUP.

https://pubmed.ncbi.nlm.nih.gov/42255328/

Results: A total of 459 patients were included, with successful CUP achieved in 316 (68.8%). Early continence was higher in the CUP cohort than in non-CUP patients (77% vs 67%, p = 0.02), while rates were similar at 12 months (83% vs. 80%, p = 0.74). CUP patients were significantly more likely to be pad-free/security pad only at both timepoints (p = 0.019 and 0.012, respectively). Positive MS rates and locations were comparable between groups. CUP was not associated with increased BCR risk on multivariable analysis (HR 1.06, 95% CI 0.56-1.98; p = 0.90). CUP likelihood improved with experience.

It appears to improve early incontinence but after a year the incontinence levels are much the same as normal RARP?

Edited by member 25 Aug 2026 at 10:29 | Reason: Add link

User

Posted 25 Aug 2026 at 14:02

That being the case, the outcome looks similar to Retzius sparing.

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