Interrupted versus Continuous Suturing for Vesicourethral Anastomosis During Radical Prostatectomy: A Systematic Review and Meta-analysis

Kowalewski, Karl‐Friedrich; Tapking, Christian; Hetjens, Svetlana; Nickel, Felix; Mandel, Philipp; Nuhn, Philipp; Ritter, Manuel; Moul, Judd W.; Thüroff, Joachim W.; Kriegmair, Maximilian C.

doi:10.1016/j.euf.2018.05.009

Cited by 9 publications

(11 citation statements)

References 47 publications

(53 reference statements)

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“…It was underlined that the suture technique should be chosen according to the surgeon's experience and technical approach. 13 In another retrospective analysis, the results of sutureless anostomosis in patients undergoing open and laparoscopic radical prostatectomy were evaluated. In this VUA technique, which is designed completely without sutures, the catheter balloon was inflated and traction was applied.…”

Section: Discussionmentioning

confidence: 99%

The effect of vesicourethral anostomosis technique on functional results in retropubic radical prostatectomy

Kızılay¹,

Kalemci

Şimşir

2021

Preprint

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Aim We aimed to compare the functional results of two different vesicourethral anostomosis (VUA) techniques used in retropubic radical prostatectomy (RRP). Methods A total of 476 patients including the first group with 4 focal VUA at 12-, 3-, 6-, and 9-o’clock positions (n = 288) and the second group with 6 focal VUA at 12-, 2-, 4-, 6-, 8- and 10-o’clock (n = 188) were included in the study. Perioperative data and erectile function and continence status over a 12-month period were compared. Results Demographic and perioperative data were similar between the two groups. The proportion of patients with VUA stricture in the first group was significantly higher than in the second group (5.1% vs 3.2%, p = 0.017). The mean time to stricture development was also shorter in the first group (48.9 vs 74.3 days, p = 0.002). In the second group, the proportion of continent patients at the sixth and twelfth months was higher than the first group (79.3% vs 62.8%, p <0.001; 92.4% vs 81.3%, p = 0.032, respectively). There was no significant difference between the two groups in terms of the proportions of potent patients (p = 0.194 for 6 months and p = 0.351 for 12 months). Conclusions Better continence results can be obtained with the six-focus VUA compared to the four-focus technique. The number of anostomotic sutures in VUA can affect functional results and may be a decisive factor for surgeons who focus on functional results as well as oncological results.

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Section: Discussionmentioning

confidence: 99%

The effect of vesicourethral anostomosis technique on functional results in retropubic radical prostatectomy

Kızılay¹,

Kalemci

Şimşir

2021

Preprint

View full text Add to dashboard Cite

show abstract

“…In a meta‐analysis, in which a total of nine studies including 1475 patients were evaluated, running suturing and interrupted suturing were compared, and although running suturing provided shorter catheterization time, anastomosis time and a lower rate of urine extravasation, no significant difference was found between continence rates and urethral stricture rates at 3, 6, and 12 months, and the length of hospital stay between the two techniques. It was underlined that the suture technique should be chosen according to the surgeon's experience and technical approach 13 . In another retrospective analysis, the results of sutureless anastomosis in patients undergoing open and laparoscopic radical prostatectomy were evaluated.…”

Section: Discussionmentioning

confidence: 99%

Effect of vesicourethral anastomosis technique on functional results in retropubic radical prostatectomy

2021

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Aim We aimed to compare the functional results of two different vesicourethral anastomosis (VUA) techniques used in open retropubic radical prostatectomy. Methods A total of 476 patients including the first group with four‐focus VUA at 12‐, 3‐, 6‐, and 9‐o'clock positions (n = 288) and the second group with six‐focus VUA at 12‐, 2‐, 4‐, 6‐, 8‐, and 10‐o'clock (n = 188) were included in the study. Perioperative data, erectile function, and continence status over a 12‐month period were compared. Results Demographic and perioperative data were similar between two groups. The number of patients with VUA stricture in the first group was significantly higher those in the second group (5.1% vs 3.2%, P = .017). The mean time to stricture development was also shorter in the first group (48.9 vs 74.3 days, P = .002). The number of continent patients at the 6th and 12th months were higher in the second group (79.3% vs 62.8%, P < .001; 92.4% vs 81.3%, P = .032, respectively). There was no significant difference between two groups in terms of the number of potent patients (P = .194 for 6 months and P = .351 for 12 months). Conclusions Better continence results can be provided with the six‐focus VUA technique compared with the four‐focus technique. The number of anastomotic sutures in VUA may affect functional results and can be a determinative factor for surgeons who focus on functional results as well as oncological results.

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“…19 Various considerations, technical features and improvements for vesicourethral anastomosis were explained by Gillizter and Thüroff. 20 The two most commonly used techniques are RS and IS. 21 Both running and interrupted sutures have specific advantages and disadvantages.…”

Section: Discussionmentioning

confidence: 99%

“…The continence rates one year after surgery is up to 90%. 30–32 It can therefore be assumed that the incontinence rate of the running group improved in due course.…”

Section: Discussionmentioning

confidence: 99%

Early Continence and Extravasation After Open Retropubic Radical Prostatectomy – Interrupted vs Continuous Suturing for Vesicourethral Anastomosis

Köhler

El-Bandar

Maxeiner

et al. 2020

TCRM

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Purpose To compare running suture (RS) and interrupted suture (IS) of vesicourethral anastomosis (VUA) during open retropubic radical prostatectomy (RRP) on early urinary continence and extravasation. Patients and Methods Single center analysis of 211 patients who underwent RRP performed by a single surgeon during 2008 to 2017 was retrospectively analyzed. For VUA, we used the standard interrupted suture technique (n=100) with a 3–0 PDS suture. The RS (n=111) was performed with 12-bite suture using 3–0 PDS. The primary endpoints were extravasation and early continence. Demographic and peri-operative data were collected and analyzed using Pearson’s chi-square, t -Test and Mann–Whitney U -test. A binary logistic regression analysis was carried out to explore predictors that affected early continence after catheter removal. Results The rates of early urinary incontinence (UI) were 7.7% vs 42.2% (p<0.001). The duration of catheterization and hospitalization was significantly shorter in the interrupted group (4 days vs 5 days, p<0.001 and 5 days vs 6 days, p<0.001). The groups did not differ significantly in body mass index or prostate volume. There were older patients and higher PSA levels in the group with RS technique. No significant difference was found in the postoperative extravasation rates between both groups (13.5% vs 12%, p=0.742). Conclusion Running vesicourethral anastomosis increased the rate of early urinary incontinence. Both anastomosis techniques provided a similar rate of postoperative urine extravasation. VUA should only be one of the many criteria that must be considered for the preservation of urinary continence of patients after RRP.

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Interrupted versus Continuous Suturing for Vesicourethral Anastomosis During Radical Prostatectomy: A Systematic Review and Meta-analysis

Cited by 9 publications

References 47 publications

The effect of vesicourethral anostomosis technique on functional results in retropubic radical prostatectomy

The effect of vesicourethral anostomosis technique on functional results in retropubic radical prostatectomy

Effect of vesicourethral anastomosis technique on functional results in retropubic radical prostatectomy

Early Continence and Extravasation After Open Retropubic Radical Prostatectomy – Interrupted vs Continuous Suturing for Vesicourethral Anastomosis

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