Vesicourethral healing following radical prostatectomy: Is it related to surgical approach?

Levy, J.B.; Ramchandani, Parvati; Berlin, Jesse; Broderick, Gregory A.; Wein, Alan J.

doi:10.1016/s0090-4295(94)80176-2

Cited by 39 publications

(16 citation statements)

References 5 publications

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“…Although this rate could be considered as high, the cohort represents our initial cases and is thus a reflection of our earliest experience with RALRP. Despite this, the reported leak rate is consistent with historical as well as contemporary RALRP data [3][4][5][6]. As well, there was a pattern of fewer anastomotic urine leaks as our experienced increased, suggesting an element of a 'learning curve' .…”

Section: Discussionsupporting

confidence: 85%

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What is the long‐term relevance of clinically detected postoperative anastomotic urine leakage after robotic‐assisted laparoscopic prostatectomy?

Rebuck¹,

Haywood²,

McDermott³

et al. 2011

BJU International

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• Univariate and multivariate analyses were performed. Outcomes were assessed at the most recent follow-up. RESULTS• Among 213 patients eligible for inclusion, 27 experienced an anastomotic urine leak (12.7%).• At a mean long-term follow-up of 24.2 months, there was no difference in SHIM scores (7.0 vs 13.1; P = 0.101), continence rates (87.5% vs 85.2%; P = 0.999) or risk of BNC (7.4% vs 3.2%; P = 0.268) between patients with and without postoperative anastomotic urine leaks, respectively.• The results did not change after controlling for covariates in a multivariate analysis.

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Section: Discussionsupporting

confidence: 85%

“…When routine cystograms are performed after retropubic radical prostatectomy, anastomotic leaks are noted to occur in 3-33% of cases [3][4][5]. A contemporary report showed that, even among patients undergoing RALRP, routine cystograms show anastomotic leakage in up to 13.6% of cases [6].…”

Section: B J U I N T E R N a T I O N A Lmentioning

confidence: 99%

What is the long‐term relevance of clinically detected postoperative anastomotic urine leakage after robotic‐assisted laparoscopic prostatectomy?

Rebuck¹,

Haywood²,

McDermott³

et al. 2011

BJU International

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“…Intraoperative and postoperative factors, such as excessive blood loss, type of bladder neck dissection, postoperative urinary leakage, adjuvant radiotherapy, previous TURP, current cigarette smoking, older age, obesity, surgeon experience, open vs. minimally invasive surgery, and acute postoperative retention treated with suprapubic tube placement also influence the VUAS rates (38,48,49,50,51,52).…”

Section: Stricture After Radical Prostatectomymentioning

confidence: 99%

Urethral Stricture is an Unpleasant Complication after Prostate Surgery: A Critical Review of Current Literature

Söğütdelen¹,

Haberal²,

Guliyev³

et al. 2016

jus

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Prostatectomy is one of the main causes of surgery in aging male population. Besides traditional techniques, novel minimally invasive approaches may also end up with certain complications following prostate surgery. Transurethral procedures may cause iatrogenic urethral trauma. Factors that may influence the development of iatrogenic endoscopic urethral strictures include "electrical dispersion" generated by unipolar current and the "diameter of the instruments" used. Those complications not only bother quality of life of the patients but also may cause various adjunctive procedures with an economical impact.Urethral stricture is the abnormal narrowing of any segment of the urethra surrounded by corpus spongiosum. It specifically means varying degrees of spongiofibrosis that refers to scarring of the corpus spongiosum (1). Any inflammation of the urethra can result in scarring that can lead to a stricture or a narrowing of the urethra. Besides prostate surgery, trauma, infections, tumors or any other cause of scarring may trigger urethral stricture (2). A recent metaanalysis including 732 patients showed that idiopathic and iatrogenic etiologies were by far the most common, accounting for 33% and 33% of all cases, respectively. Inflammatory and posttraumatic etiologies were found in only 15% and 19% of patients, respectively (3).Here, we tried to review the incidence and the basic risk factors that cause urethral stricture following prostate surgery. ÖZÜretral striktür enflamasyona bağlı olarak skarlaşma sonrası üretradaki daralmadır. Elli yaş üzeri erkeklerde benign ve malign hastalıklara bağlı olarak yapılan prostatektomiler oldukça yaygın olarak uygulanmaktadır. Prostatın transüretral rezeksiyonu sonrası farklı serilerde %19'a kadar çıkan oranlarda üretral darlık ve mesane boynu kontraksiyonu görülmektedir. Lazer prostatektomi sonrası üretral darlık prostatın transüretral rezeksiyonuna oranla daha az olarak görülmektedir, yaklaşık olarak %3,6 oranındadır. Açık prostatektomi en eski yöntem olmasına rağmen büyük prostat boyutlu hastalarda oldukça mantıklı bir alternatiftir. Açık prostatektomi sonrası yaklaşık olarak %1,9-4,8 oranında darlık bildirilmiştir. Radikal prostatektomi (RP) lokalize prostat kanseri tedavisinde bütün dünyada en yaygın olarak uygulanan yöntemdir. RP sonrası anastomoz seviyesinde mesane boynu kontraksiyonu olması iyi bilinen bir komplikasyondur ve yaklaşık olarak hastaların %0,4-32'sinde görülmektedir. Darlık büyük oranda endoskopik yöntemlerle tedavi edilmektedir, nadiren komplike olgularda bukkal mukoza greftli üretroplasti gerekebilmektedir. Anahtar Kelimeler: Üretral darlık, prostat cerrahisi, transüretral rezeksiyon, açık prostatektomi, radikal prostatektomi ABSTRACTUrethral stricture is narrowing of the urethra due to inflammation that results in scarring. Prostatectomies for benign and malign prostatic diseases are common surgical procedures among men mainly after their fifties. Urethral stricture or bladder neck contraction following transurethral resection of the prostate (TURP)...

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“…This percentage comes to 14% in the report of Levy et al [10], and to 11.5% of 156 cases in the report of Surya et al [11]. We experienced anastomotic obstruction requiring a periodical bougie application on an outpatient basis in 1 of the 15 patients (6.7%).…”

Section: Discussionmentioning

confidence: 70%

Vesicourethral Anastomotic Suture Placement during Radical Prostatectomy Using Maniceps

Yamada

Honda²,

Nakamura³

et al. 2003

Urol Int

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Introduction: A new method of using a semiautomatic device (Maniceps) for precise vesicourethral anastomosis during radical retropubic prostatectomy is described. Methods: A total of 15 patients underwent radical retropubic prostatectomy with this technique. The follow-up period ranged from 6 to 16 months. The retrograde urethrocystography was performed at 2 weeks. Patients were evaluated specifically for anastomotic time, anastomotic obstruction and urinary continence. Results: The average anastomotic time was 8.1 (range 5–12) min. The catheter of all patients could be removed at 2 weeks. Anastomotic obstruction occurred in 1 patient (6.7%), and 14 patients (93.3%) were completely continent of urine. Conclusion: Maniceps is a useful procedure to carry out vesicourethral anastomosis safely, easily and surely, and it has provided good surgical results in our experience.

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Vesicourethral healing following radical prostatectomy: Is it related to surgical approach?

Cited by 39 publications

References 5 publications

What is the long‐term relevance of clinically detected postoperative anastomotic urine leakage after robotic‐assisted laparoscopic prostatectomy?

What is the long‐term relevance of clinically detected postoperative anastomotic urine leakage after robotic‐assisted laparoscopic prostatectomy?

Urethral Stricture is an Unpleasant Complication after Prostate Surgery: A Critical Review of Current Literature

Vesicourethral Anastomotic Suture Placement during Radical Prostatectomy Using Maniceps

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