Optimizing the formation of vesicourethral anastomosis and reduction of procedure time. A two-year experience with a modified technique for endoscopic running vesicourethral anastomosis

INTRODUCTION - Creation of a watertight vesicourethral anastomosis is a challenging and time-consuming procedure. In an attempt to simplify this critical step of radical prostatectomy we have developed a laparoscopic running single suture technique and presented preliminary results previously.

Here we report our two-year experience with the Chlosta's single running suture technique.

MATERIALS AND METHODS - Between January 2013 and June 2014, 60 consecutive patients underwent laparoscopic radical prostatectomy with a running vesicourethral anastomosis using our modified technique for clinically localized prostate cancer. Analyses of the patients' data from a prospectively maintained database with respect to perioperative characteristics, morbidity and urinary continence was performed.

RESULTS - The mean anastomotic time was 10. 2 min. There was no clinically significant anastomotic leakage observed. Only 3 patients developed perioperative morbidity, but none of them was classified as major. Bladder neck contracture occurred in only one man and it was managed endoscopically. Overall continence rates at 3, 6, 12, and 18 months were 73%, 85%, 96. 7%, and 95%, respectively, and 76. 8%, 89. 3%, 96. 4%, and 96. 4%, respectively when analysis was limited to those without adjuvant radiotherapy.

CONCLUSIONS - Obtained results confirm our initial observation from the preliminary report and support the use of our single running suture for the vesicourethral anastomosis in LRP.

Central European journal of urology. 2015 Sep 07 [Epub]

Tomasz Golabek, Tomasz Wiatr, Mikolaj Przydacz, Jakub Bukowczan, Przemyslaw Dudek, Robert Sobczynski, Katarzyna Golabek, Piotr L Chłosta

Department of Urology, Collegium Medicum at the Jagiellonian University, Cracow, Poland. , Department of Urology, Collegium Medicum at the Jagiellonian University, Cracow, Poland. , Department of Urology, Collegium Medicum at the Jagiellonian University, Cracow, Poland. , Department of Endocrinology and Diabetes Mellitus, Diabetes Resource Centre, North Tyneside General Hospital, North Shields, United Kingdom. , Department of Urology, Collegium Medicum at the Jagiellonian University, Cracow, Poland. , Department of Cardiovascular Surgery and Transplantology The John Paul II Hospital, Cracow, Poland. , Sucha Beskidzka Regional Clinic, Sucha Beskidzka, Poland. , Department of Urology, Collegium Medicum at the Jagiellonian University, Cracow, Poland.

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