You have accessJournal of UrologyImaging/Radiology: Uroradiology I1 Apr 20122042 EVALUATION OF THE VESICOURETHRAL ANASTOMOSIS POST RADICAL PROSTATECTOMY - TRANSRECTAL ULTRASOUND VERSUS CYSTOGRAPHY Andreas Bannowsky, Nasim Mosaheb, Alexandra Raileanu, Samer Schakaki, Isis Vollmer, Klaus-Peter Jünemann, and Hermann van Ahlen Andreas BannowskyAndreas Bannowsky Osnabrück, Germany More articles by this author , Nasim MosahebNasim Mosaheb Osnabrück, Germany More articles by this author , Alexandra RaileanuAlexandra Raileanu Osnabrück, Germany More articles by this author , Samer SchakakiSamer Schakaki Osnabrück, Germany More articles by this author , Isis VollmerIsis Vollmer Osnabrück, Germany More articles by this author , Klaus-Peter JünemannKlaus-Peter Jünemann Kiel, Germany More articles by this author , and Hermann van AhlenHermann van Ahlen Osnabrück, Germany More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.2206AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Evaluation of the vesicourethral anastomosis after radical retropubic prostatectomy in prostate cancer is usually perfomed by cystography. The transrectal ultrasound of the prostate (TRUS) is mainly utilized to get anatomical information like volume determination, tumor detection and extension. In a prospective, two-institutional study we compared TRUS with cystography after radical retropubic prostatectomy in the evaluation of the vesicourethral anastomosis. METHODS In 212 patients the vesicourethral anastomosis was evaluated by TRUS (7 MHz) followed immediately by cystography on day 7-14 after radical prostatectomy. Sonographically all patients were evaluated for hematomas, lymphoceles and leakages of the anastomosis, controlled by irrigation (100 - 120 ml 0.9% saline solution) during real time TRUS examination. All TRUS and “x-ray” findings, duration of the examination and dose of radiation were separately documented and compared. Leakages and hematomas (cystogram: bladder displacements or impressions) were compared with the TRUS findings and statistically evaluated. RESULTS 52 of the 212 patients (24.5%) showed an extravasation. In 39 cases (18.4%) this was seen by cystography and TRUS. 9 patients (4.2%) with leakage, were identified only by TRUS without radiographic correlation. The topographic localisation of the leakage was in 94% the dorsal part of the anastomosis. In 12 cases (5.6%) hematomas were identified only by TRUS without any correlation in the cystography, 5 in continuity with the anastomosis were responsible for a persisting hematuria and 2 were the cause for temporary bladder outlet obstruction. The source for bladder impressions due to paravesical lymphoceles could be identified by TRUS in 10 cases (4.7%). The duration of examination differed significantly with 5.4 minutes for TRUS vs. 8.7 minutes for cystography. No significant differences existed between the two institutions. CONCLUSIONS In the evaluation of the anastomosis after radical prostatectomy TRUS shows the same efficiency as the usually perfomed cystography. It allows an online assessment of postoperative topography, like hematomas or lymphoceles, and dynamic evaluation (exact localisation and dimension) of inefficient anastomosis omitting the cystography. The radiation exposition for the medical staff and patient can be reduced by using TRUS. Treatment costs e.g. x-ray and contrast medium are decreased. Due to the good results TRUS replaced the cystography at the two institutions participated in this study. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e824 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Andreas Bannowsky Osnabrück, Germany More articles by this author Nasim Mosaheb Osnabrück, Germany More articles by this author Alexandra Raileanu Osnabrück, Germany More articles by this author Samer Schakaki Osnabrück, Germany More articles by this author Isis Vollmer Osnabrück, Germany More articles by this author Klaus-Peter Jünemann Kiel, Germany More articles by this author Hermann van Ahlen Osnabrück, Germany More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...