Urine colour after radical prostatectomy predicts urinary leakage at the vesicourethral anastomosis

Abstract

A cystography can be omitted if the patient demonstrates a clear urine colour on POD 8, without an increased risk of missing a perianastomotic extravasation.

Side-fenestrated catheter decreases leakage at the urethrovesical anastomosis after robot-assisted laparoscopic radical prostatectomy

“…It is speculated that para-anastomotic haematoma may damage the anastomosis [26], which may be visually detected as blood-coloured urine during catheterization [27]. In the present study, the patients with leakage had higher but non-significant blood loss During reconstruction of the urethrovesical anastomosis, the bladder is pulled down to the pelvic floor to fill the gap of the removed prostatic urethra.…”

Urine colour as an indicator for anastomotic leakage after robot-assisted radical prostatectomy

“…RALP procedures were carried out with the aid of a four-arm da Vinci S robot (da Vinci; Intuitive Surgical, Sunnyvale, CA, USA). The detailed surgical technique has been described previously [17].…”

“…A two-way silicone Ch18 Foley urethral catheter (Folysil; Coloplast, Denmark) was used. An urethral catheter was fenestrated at the site of urethrovesical anastomosis to decrease the risk of urethrovesical anastomosis leak [17]. Intraoperative flush test of the anastomosis was performed by filling the bladder with 100 ml of saline.…”

“…We assumed that there would be a vesicourethral anastomosis leakage rate of 8% based on a previously published study [17]. In order to reach a of 0.80 sensitivity and specificity assuming this leakage rate, we estimated that we would need 201 patients or 17 anastomotic leakages.…”

“…The postoperative factors which increase the anastomotic leak are postoperative urinary tract infection [15] and pelvic para-anastomotic haematoma [15]. In addition, a bloody urine colour is a predictive factor for urethrovesical anastomotic leakage [16][17].…”