All You Need to Know About Urethrovesical Anastomotic Urinary Leakage Following Radical Prostatectomy

Tyritzis, Stavros Ι.; Katafigiotis, Ioannis; Constantinides, Constantinos

doi:10.1016/j.juro.2012.03.126

Cited by 67 publications

(56 citation statements)

References 48 publications

(38 reference statements)

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“…Urethrovesical anastomotic leak is one of the most common complications after radical prostatectomy with an incidence of 0.3-15.4% [1]. Many factors have been associated with urethrovesical anastomotic leak, such as patient characteristics, surgeon experience and the technical details of the procedure [1].…”

Section: Discussionmentioning

confidence: 99%

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Total urethrovesical anastomotic disruption

Chen¹,

Mackowski²

2015

IJCRI

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International Journal of Case Reports and Images (IJCRI) is an international, peer reviewed, monthly, open access, online journal, publishing high-quality, articles in all areas of basic medical sciences and clinical specialties.Aim of IJCRI is to encourage the publication of new information by providing a platform for reporting of unique, unusual and rare cases which enhance understanding of disease process, its diagnosis, management and clinico-pathologic correlations.

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Section: Discussionmentioning

confidence: 99%

“…Many factors have been associated with urethrovesical anastomotic leak, such as patient characteristics, surgeon experience and the technical details of the procedure [1]. It is reasonable to assume that disruption of the anastomosis is associated with the same factors.…”

Section: Discussionmentioning

confidence: 99%

Total urethrovesical anastomotic disruption

Chen¹,

Mackowski²

2015

IJCRI

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“…Age, smoking, diabetes mellitus, hypertension and prostate volume were not found to be associated with anastomotic leakage. However, obesity and excessive bleeding were associated with decreased visibility of the bladder neck, hampering suture placement in urethro-vesical anastomosis [14] . As a surgical factor, non-eversion of the mucosa was suggested for tighter anastomosis instead of eversion [15] .…”

Section: Urine Leakagementioning

confidence: 99%

“…Uroperitoneum is the most serious short-term complication of the urine leakage, and may lead to peritonitis, deterioration in renal functions and ileus. Before the reoperation decision, pelvic drain or nephrostomy tube can be placed [14] .…”

Section: Urine Leakagementioning

confidence: 99%

Robotic urologic surgery complications

Koç¹,

Canda²

2018

MIS

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Robot-assisted surgery is a commonly performed procedure in the recent urological approach. The scientific data that reveal the complication rates also tend to increase by the rising popularity of the robot-assisted surgeries in the treatment of urological cancers. Patient characteristics, nature of the cancer and learning curve of the surgeon are the determinant factors of the complication rates. Nevertheless, robot-assisted surgical techniques are safer with acceptable morbidity and mortality rates as compared to open surgical methods. In urology practice, robotic surgery is most commonly performed in the treatment of prostate cancer. Thus, this review subjected to reveal the commonly seen and the serious complications of robot-assisted radical prostatectomy, and their prevention and management.

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“…An ideal VUA should prevent urine leak and facilitates earlier return to continence. This is a key operative step as the presence of urinary leak can be associated with adverse outcomes including paralytic ileus, prolonged catheterization, urinary peritonitis, bladder neck contracture (BNC) and impaired urinary function (3)(4)(5). Historically, the VUA has been recreated with six interrupted absorbable sutures, as described by Walsh et al (6).…”

Section: Introductionmentioning

confidence: 99%

Comparative trial assessing suture techniques and types of urinary catheters in vesicourethral anastomotic tensile strength in a porcine model

Perera

Divakaran

Roberts

et al. 2017

Journal of the Mechanical Behavior of Biomedical Materials

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Cite this article as: Marlon Perera, Pranav Divakaran, Matthew Roberts and Eric Chung, Comparative trial assessing suture techniques and types of urinary catheters in vesicourethral anastomotic tensile strength in a porcine model, Journal of the Mechanical Behavior of Biomedical Materials, http://dx.doi.org/10.1016Materials, http://dx.doi.org/10. /j.jmbbm.2016 This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting galley proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. MethodsMale porcine bladders were obtained and prostatectomy was performed. The specimens were randomized and VUA were created using 3-point interrupted, 6-point interrupted or 6 point continuous 3-0 monocryl suture. 20Fr catheters were utilized, specifically varying manufacturers (A and B) and catheter balloon shapes (round versus oval). The VUA model was placed within a reproducible pulley system and graduated weights were applied util failure of the catheter balloon or the model VUA. Model failure was defined as either 'VUA rupture', 'Catheter passage through VUA' or 'catheter failure'. ResultsTwenty consecutive porcine bladders were prepared, tested and utilized for analysis. VUA reconstructed with 3-point fixation was more likely to suffer VUA rupture (p=0.025) compared to 6-point interrupted or 6-point continuous VUA. Higher tensile pressure causing catheter balloon rupture (p=0.009) was observed for Manufacturer A. Catheters with ovalballoon shape were more likely to dislodge past the VUA without disruption of the anastomosis (p=0.002). ConclusionsDuring prostatectomy, anastomotic technique and catheter selection can significantly alter the tensile properties of the VUA. Further research is required to validate our findings in clinical models.3

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All You Need to Know About Urethrovesical Anastomotic Urinary Leakage Following Radical Prostatectomy

Abstract: We gathered all relevant critical information concerning urethrovesical anastomotic leak to encourage standardization in the diagnosis and management of this common complication. Systematic meta-analysis of each debatable issue is required to provide definite answers.

Cited by 67 publications

References 48 publications

Total urethrovesical anastomotic disruption

Total urethrovesical anastomotic disruption

Robotic urologic surgery complications

Comparative trial assessing suture techniques and types of urinary catheters in vesicourethral anastomotic tensile strength in a porcine model

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