Managing urine leakage following laparoscopic radical prostatectomy with active suction of the prevesical space - Abstract

INTRODUCTION: Urine leakage following laparoscopic radical prostatectomy (LRP) is a possible complication that may herald chronic urine incontinence. Intraoperative measures aiming to prevent this is not standardised.

AIM: Presentation of experience with active suction of the prevesical space in managing postoperative urine leakage.

MATERIAL AND METHODS: At the Department of Urology, where laparoscopy of the upper abdomen and open RP were performed, a protocol for extraperitoneal LRP was established in 8/2008. Until 5/2011, 154 LRPs have been performed. Urine leakage from a suction drain appeared in 9 cases (5.8%). Permanent active suction (with a machine for Büllae thoracic drainage) of the prevesical space with negative pressure of 7-12 cm of H2O was started immediately.

RESULTS: Urine leakage started after a mean of 0.9 (0-2) days postoperatively and stopped after a mean of 8.1 (15-42) days. Leakage stopped with only suctioning in 7 cases. In one case, open re-anastomosis was performed on the 7th postoperative day (POD). In another case, ineffective active suction was replaced on the 10th POD by needle vented suction without effect and the leakage stopped following gradual shortening of the drain up to the 15th POD.

CONCLUSIONS: Active suction of the prevesical space seems to be an effective intervention to stop postoperative urine leakage after laparoscopic radical prostatectomy.

Written by:
Hora M, Stránský P, Klečka J, Trávníček I, Urge T, Eret V, Ferda J, Petersson F, Hes O.   Are you the author?
Department of Urology, Faculty Hospital, Pilsen, Czech Republic; Faculty of Medicine, Charles University, Pilsen, Czech Republic.

Reference: Wideochir Inne Tech Malo Inwazyjne. 2013 Mar;8(1):49-54.
doi: 10.5114/wiitm.2011.31533. Epub 2012 Oct 30

PubMed Abstract
PMID: 23630554 Prostate Cancer Section