When and how should we test the tightness of the vesicourethral anastomosis after retropubic radical prostatectomy?

Urol Int. 2011;86(4):388-92. doi: 10.1159/000323660. Epub 2011 Feb 17.

Abstract

Objective: To determine when the vesicourethral anastomosis (VUA) becomes tight after retropubic radical prostatectomy (RRP) and if an additional lateral view cystography provides significantly more information than the only anterior-posterior view.

Patients and methods: Pressure-controlled cystography with anterior-posterior and lateral views was performed on postoperative days (POD) 3, 6 and 9 and evaluated in 100 consecutive patients after RRP.

Results: On POD 3, 6 and 9, 82, 80 and 82% of all VUA, respectively, were tight. 85% of all tight VUA on POD 3 remained tight on POD 6 and 9. Of the 52 extravasations in a total of 300 cystographies, 65% were recognizable in the anterior-posterior as well as in the lateral view cystography, 6% were seen only in the anterior-posterior view and 29% only in the lateral view.

Conclusions: The VUA after RRP is tight in about 80% of the cases on POD 3, 6 and 9. A tight VUA on POD 3 does not exclude later extravasation on POD 6 and 9 (14%). About one third (29%) of all extravasations of VUA are seen only in the lateral view cystography after RRP.

MeSH terms

  • Aged
  • Anastomosis, Surgical / methods*
  • Humans
  • Lymph Nodes / pathology
  • Male
  • Middle Aged
  • Pressure
  • Prostatectomy / adverse effects*
  • Prostatectomy / methods
  • Surgical Procedures, Operative
  • Time Factors
  • Urethra / surgery
  • Urinary Bladder / pathology