Effect of vesicourethral anastomosis technique on functional results in retropubic radical prostatectomy

Int J Clin Pract. 2021 Sep;75(9):e14460. doi: 10.1111/ijcp.14460. Epub 2021 Jun 27.

Abstract

Aim: We aimed to compare the functional results of two different vesicourethral anastomosis (VUA) techniques used in open retropubic radical prostatectomy.

Methods: A total of 476 patients including the first group with four-focus VUA at 12-, 3-, 6-, and 9-o'clock positions (n = 288) and the second group with six-focus VUA at 12-, 2-, 4-, 6-, 8-, and 10-o'clock (n = 188) were included in the study. Perioperative data, erectile function, and continence status over a 12-month period were compared.

Results: Demographic and perioperative data were similar between two groups. The number of patients with VUA stricture in the first group was significantly higher those in the second group (5.1% vs 3.2%, P = .017). The mean time to stricture development was also shorter in the first group (48.9 vs 74.3 days, P = .002). The number of continent patients at the 6th and 12th months were higher in the second group (79.3% vs 62.8%, P < .001; 92.4% vs 81.3%, P = .032, respectively). There was no significant difference between two groups in terms of the number of potent patients (P = .194 for 6 months and P = .351 for 12 months).

Conclusions: Better continence results can be provided with the six-focus VUA technique compared with the four-focus technique. The number of anastomotic sutures in VUA may affect functional results and can be a determinative factor for surgeons who focus on functional results as well as oncological results.

MeSH terms

  • Anastomosis, Surgical
  • Humans
  • Male
  • Prostatectomy
  • Prostatic Neoplasms* / surgery
  • Urethra* / surgery
  • Urinary Bladder / surgery