Document Detail


Detection of urinary leakage after radical retropubic prostatectomy by contrast enhanced ultrasound - do we still need conventional retrograde cystography?
MedLine Citation:
PMID:  20590540     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: To prospectively evaluate the accuracy of transvesical contrast-enhanced ultrasound (CEUS) as an alternative method for the detection of anastomotic leakage after radical retropubic prostatectomy (RRP) in comparison with the current standard method of conventional retrograde cystography (CG).
PATIENTS AND METHODS: Forty-three patients underwent RRP for histologically proven localized prostate cancer. The vesico-urethral anastomosis was evaluated 8 days after RRP by CG and CEUS. Any peri-anastomotic leakage was assessed and determined in CG and CEUS as follows: no extravasation (EV), small leakage (≤0.5 cm), moderate leakage (>0.5 cm to ≤2 cm), large leakage (>2 cm diameter of EV seen).
RESULTS: In total, 21 (49%) patients showed a watertight anastomosis. Ten (23%), two (4.7%) and ten (23%) patients showed a small, intermediate and large EV, respectively. In 31 cases (72%) there was 100% agreement of CG and CEUS for detection of no, moderate and large EV, respectively. In nine cases a small and in two cases a moderate EV was categorized as watertight anastomosis by CEUS. Only in one case did CG detect a small EV where a large EV was detected in CEUS. The agreement between both methods was 95% for detecting absence or large leakages.
CONCLUSION: CEUS is a promising imaging modality that seems to be equivalent to CG for detecting the presence of a large anastomotic leakage that is clinically relevant for postoperative persistence of the indwelling catheter. CEUS could be a cheap and time-saving alternative to the CG without exposure of the patient to radiation.
Authors:
Gita M Schoeppler; Alexander Buchner; Dirk Zaak; Wael Khoder; Michael Staehler; Christian G Stief; Maximilian F Reiser; Dirk-Andre Clevert
Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  BJU international     Volume:  106     ISSN:  1464-410X     ISO Abbreviation:  BJU Int.     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-11-16     Completed Date:  2011-01-04     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100886721     Medline TA:  BJU Int     Country:  England    
Other Details:
Languages:  eng     Pagination:  1632-7     Citation Subset:  IM    
Copyright Information:
© 2010 THE AUTHORS. JOURNAL COMPILATION © 2010 BJU INTERNATIONAL.
Affiliation:
Department of Urology, University Hospitals - Grosshadern, Ludwig-Maximilians-University Munich, Munich, Germany. gita.schoeppler@umm.de
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MeSH Terms
Descriptor/Qualifier:
Aged
Anastomosis, Surgical
Anastomotic Leak / ultrasonography*
Contrast Media / diagnostic use
Cystoscopy
Epidemiologic Methods
Humans
Male
Middle Aged
Prostatectomy / adverse effects*
Prostatic Neoplasms / surgery*
Urethra / surgery*,  ultrasonography
Urinary Bladder / surgery*,  ultrasonography
Urinary Catheterization / adverse effects*
Chemical
Reg. No./Substance:
0/Contrast Media

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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