1324 A RANDOMIZED STUDY OF VESICO-URETHRAL ANASTOMOSIS COMPARING RUNNING SUTURE WITH CONVENTIONAL INTERRUPTED SUTURE IN PATIENTS WITH RETROPUBIC RADICAL PROSTATECTOMY

Abstract

You have accessJournal of UrologyProstate Cancer: Localized VI1 Apr 20121324 A RANDOMIZED STUDY OF VESICO-URETHRAL ANASTOMOSIS COMPARING RUNNING SUTURE WITH CONVENTIONAL INTERRUPTED SUTURE IN PATIENTS WITH RETROPUBIC RADICAL PROSTATECTOMY Hideyasu Matsuyama, Shigeru Sakano, Takahiko Hara, Hiroaki Matsumoto, and Yoshihisa Kawai Hideyasu MatsuyamaHideyasu Matsuyama Ube, Japan More articles by this author , Shigeru SakanoShigeru Sakano Ube, Japan More articles by this author , Takahiko HaraTakahiko Hara Ube, Japan More articles by this author , Hiroaki MatsumotoHiroaki Matsumoto Ube, Japan More articles by this author , and Yoshihisa KawaiYoshihisa Kawai Ube, Japan More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.1706AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Although interrupted suture is a standard technique of vesico-urethral anastomosis in open retropubic radical prostatectomy (RRP), urine leakage from anastomosis could delay the catheter removal, and may influence postoperative unfavorable events including urethral stricture, or recovery of continence. Objectives of the study is to study if different suture techniques of the vesico-urethral anastomosis may influence the postoperative condition. METHODS Totally, 108 patients who had undergone retropubic radical prostatectomy at our hospital from 2008 to 2011 were included in this study. Patients were randomly assigned to running suture group (RS, 54 pts.), or interrupted suture group (IS, 54 pts.). IS was performed by conventional 6 (1, 3, 5, 7, 9, 11 o'clock) interrupted suture using 2-0 polyglactin. RS was performed by 12 bite running sutures starting from 6 to 12 o'clock direction using 3-0 poliglecaprone. Urethro-cystography was routinely performed on POD 5-7. Removal of the catheter was postponed until disappearance of extravasation. Primary endpoint of the study was frequency of extravasation at first urethra-cystography, and secondary endpoints were frequency of postoperative stricture, % incontinent volume at discharge, Social continence rate (0-1 pad/day) at 1, 3, 6, and 12 months after surgery. RESULTS The mean age of the patient was 66.6 year. There was no statistical difference of patient background (clinical stage, biopsy Gleason score, D'Amico risk classification) between two groups. There was no statistical difference of suturing time between two groups (RS: 23.3min. vs. IS: 19.9min., p=0.1282). Frequency of extravasation and % incontinent volume at discharge was significantly higher in IS group as compared with that in RS group (38.5% vs. 9.8%, p=0.001, 38.4 % vs. 24.6%, p=0.0228, respectively). Postoperative hospital stay of IS was significantly longer than that of RS (p=0.037). Social continence rate of RS group at 3month were significantly higher than that of IS group (73.8% vs.45.8%, p=0.0336), although not significant at 6 (82.1% vs.68.0%), 12 months (93.8% vs. 88.6%). As for complication, urethral stricture for which postoperative intervention was needed was noted in 4 (7.7%) in IS, 2 (3.9%) in RS, respectively. CONCLUSIONS Running suture of vesico-urethral anastomosis may be feasible technique even in non-laparoscopic RRP, and is likely to have an advantage of early recovery of continence. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e537 Peer Review Report Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Hideyasu Matsuyama Ube, Japan More articles by this author Shigeru Sakano Ube, Japan More articles by this author Takahiko Hara Ube, Japan More articles by this author Hiroaki Matsumoto Ube, Japan More articles by this author Yoshihisa Kawai Ube, Japan More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...