Objectives To evaluate surgical outcomes, urinary continence and survival in dogs with stage T < 4 prostatic tumours or preneoplastic lesions treated with nerve‐sparing total prostatectomy. Materials and Methods A retrospective review of 22 dogs that underwent nerve‐sparing total prostatectomy between 2018 and 2024 was conducted. Inclusion criteria included histologically confirmed prostatic neoplasia or preneoplastic lesions, complete preoperative staging (contrast‐enhanced CT and urethrocystoscopy), absence of nodal or distant metastases (N0, M0) and no invasion of adjacent structures (<T4). Data collected included surgical complications, urinary continence (modified Byron scale), histopathology, adjuvant treatment, tumour progression and survival. Results Fifteen dogs were staged as T2N0M0, five as T3N0M0 and two as T1N0M0. The average surgical time was 72.5 minutes. One minor intraoperative complication occurred, with no major postoperative complications observed. All dogs were incontinent immediately after catheter removal; however, improvement was seen in all cases during follow‐up. Fifteen dogs (68.2%) regained full continence, while seven (31.8%) experienced persistent mild (grade 1) incontinence. No dogs developed severe permanent incontinence. Tumour progression was observed in six dogs (27.3%) at a median of 150 days post‐surgery. The median follow‐up and survival times were 570 and 900 days, respectively. Clinical Significance In carefully selected dogs with early‐stage (T < 4) prostatic disease, nerve‐sparing total prostatectomy is associated with a low complication rate, favourable long‐term continence and encouraging survival outcomes. This approach offers a viable treatment option for dogs with limited local disease.
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