Document Detail

Long-term functional urinary outcomes comparing single- vs double-layer urethrovesical anastomosis: two-year follow-up of a two-group parallel randomized controlled trial.
MedLine Citation:
PMID:  20869107     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: To evaluate long-term urinary outcomes in participants of a two-group randomized clinical trial comparing continence after robotic prostatectomy (RP) between those who had reconstruction of the rhabdosphincter and puboprostatic collar (double-layer anastomosis) with those who had not.
METHODS: Consecutive patients (n = 116) undergoing RP at a single institution were randomized to either single- or double-layer urethrovesical (UV) anastomosis between August and December of 2007. Patients were contacted an average of 23.5 months postoperatively. A survey was performed by a third-party assessor blinded to the intervention, to evaluate urinary outcomes by International Prostate Symptom Score (IPSS), pad usage, and pad weight for those with persistent incontinence.
RESULTS: Follow-up at 2 years was 86.5%. There was no statistically significant difference in demographic or preoperative functional variables between groups. There was no difference between groups regarding urine leakage weights, pad usage rates, long-term IPSS score, or IPSS bother score. Both patients in the cohort with incontinence and both with bladder neck contracture (requiring a single dilation) were in the single-layer UV anastomosis group (not significant), yet these patients had not experienced an anastomotic leak at one week.
CONCLUSIONS: Long-term functional urinary outcomes were excellent for patients undergoing RP with either single- or double-layer UV anastomosis. IPSS scores and pad usage rates and weights were equivalent between groups. Although patients with single-layer anastomoses were more likely to have a leak at one-week cystogram and longer duration of catheter placement, this did not lead directly to bladder neck contracture or incontinence.
Jesse D Sammon; Fred Muhletaler; James O Peabody; Mireya Diaz-Insua; Ramgopal Satyanaryana; Mani Menon
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Urology     Volume:  76     ISSN:  1527-9995     ISO Abbreviation:  Urology     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-11-08     Completed Date:  2010-12-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0366151     Medline TA:  Urology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1102-7     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 Elsevier Inc. All rights reserved.
Vattikuti Urology Institute, Henry Ford Health System, Detroit, Michigan 48202, USA.
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MeSH Terms
Anastomosis, Surgical / adverse effects,  methods
Middle Aged
Prostatectomy / adverse effects*,  methods
Urethra / surgery*
Urinary Bladder / surgery*
Urinary Incontinence / etiology*
Comment In:
Urology. 2010 Nov;76(5):1107; author reply 1107-8   [PMID:  21056256 ]

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

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