Document Detail


Reducing the number of sutures for vesicourethral anastomosis in radical retropubic prostatectomy.
MedLine Citation:
PMID:  19409119     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To prospectively evaluate the outcome of using a two-suture technique for the vesicourethral anastomosis (VUA) during radical retropubic prostatectomy (RRP). MATERIALS AND METHODS: Two groups of 50 patients each underwent nerve-sparing RRP for localized prostate cancer by one surgeon. In one group, the vesicourethral anastomosis was performed using 2 Vicryl 2-0 stitches placed at the 3- and 9-o'clock positions and in the other group 6 Vicryl 2-0 stitches were placed at the 2-, 4-, 6-, 8-, 10- and 12-o'clock positions. The intraoperative and perioperative parameters analyzed were time to perform the VUA, time to remove the drain and hospitalization. The rate of incontinence, anastomotic stricture and erectile function were included in the outcome analysis. RESULTS: The anastomotic time differed statistically between the 2 groups (mean 3.3 minutes for the 2-suture group and 10.5 minutes for the 6-suture group, p < 0.0001) with similar periods of drain removal (mean 3.12 days for the 2-suture group and 3.45 days for the 6-suture group; p = 0.13) and hospitalization (mean 4.66 days for the 2-suture group and 5.3 days for the 6-suture group; p = 0.09). The functional outcome was excellent for the 2-suture group with no patient suffering from incontinence or anastomotic strictures 1 year postoperatively, while in the 6-suture group there were 2 patients (4%) suffering from incontinence (2 underwent sling procedure) and 1 patient suffered from anastomotic stricture. CONCLUSION: The low number of sutures in the 2-suture VUA technique reduces operating times, does not influence perioperative and intraoperative parameters and results in excellent functional outcome.
Authors:
Evangelos M Mazaris; Eleftherios Chatzidarellis; Ioannis M Varkarakis; Athanasios Dellis; Charalambos Deliveliotis
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  International braz j urol : official journal of the Brazilian Society of Urology     Volume:  35     ISSN:  1677-6119     ISO Abbreviation:  Int Braz J Urol     Publication Date:    2009 Mar-Apr
Date Detail:
Created Date:  2009-05-04     Completed Date:  2010-02-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101158091     Medline TA:  Int Braz J Urol     Country:  Brazil    
Other Details:
Languages:  eng     Pagination:  158-63     Citation Subset:  IM    
Affiliation:
Second Department of Urology, Sismanoglio Hospital, University of Athens, Athens, Greece. evmazaris@yahoo.gr
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MeSH Terms
Descriptor/Qualifier:
Aged
Anastomosis, Surgical / methods
Chi-Square Distribution
Feasibility Studies
Humans
Male
Middle Aged
Prospective Studies
Prostatectomy / methods*
Prostatic Neoplasms / surgery*
Suture Techniques / standards*
Time Factors
Treatment Outcome
Urethra / surgery*
Urinary Bladder / surgery*

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


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