Classification urine leakage from urethrovesical anastomosis after prostatectomy

Abstract

Background. Urine leakage from urethrovesical anastomosis (UVA) is a frequent and significant complication after prostatectomy.Aim. To determine frequency urine leakage from the anastomosis after prostatectomy, evaluate diagnostic methods, develop classification and management guidelines for patients with this complication.Materials and methods. A retrospective analysis of 1426 patients who underwent prostatectomy was performed. Results. In total, 97 (6.8 %) patients developed UVA failure in the early postoperative period. The complication was diagnosed on the 7th day after prostatectomy using retrograde cystography. An original classification urine leakage from the anastomosis after prostatectomy was proposed using numbers (0, I, II, III) and letters (A, B, C). In 50 (3.4 %) patients, grade I (A, B, C) UVA failure was diagnosed; 38 (2.7 %) patients had grade II (A, B, C) UVA failure; 9 (0.6 %) patients had grade III (A, B) UVA failure. The developed classification allows to accurately determine the severity of UVA failure and apply the appropriate methods for its correction.Conclusion. Urine leakage from UVA is a serious problem in surgical treatment of prostate cancer. Currently, it is necessary to systematize the available data and introduce unified classification and algorithm for correcting this complication into clinical practice.