Korean J Urol.  2013 May;54(5):297-302. 10.4111/kju.2013.54.5.297.

Prevalence and Risk Factors of Bladder Neck Contracture After Radical Prostatectomy

• Cho HJ
• Jung TY
• Kim DY
• Byun SS
• Kwon DD
• Oh TH
• Ko WJ
• Yoo TK

• KMID: 2061510
• DOI: http://doi.org/10.4111/kju.2013.54.5.297

Abstract

PURPOSE
To evaluate the prevalence of bladder neck contracture (BNC) and its risk factors in patients undergoing radical prostatectomy in Korea.
MATERIALS AND METHODS
We analyzed data from 488 patients with prostatic cancer who underwent radical prostatectomy performed by seven surgeons in seven hospitals, including 365 open radical prostatectomies (ORPs), 99 laparoscopic radical prostatectomies (LRPs), and 24 robot-assisted laparoscopic radical prostatectomies (RARPs). Patients with BNCs were compared with those without BNCs to identify the risk factors for BNC occurrence.
RESULTS
Overall, BNCs occurred in 21 of 488 patients (4.3%): 17 patients (4.7%) who underwent ORP, 4 patients (4%) who underwent LRP, and no patients who underwent RARP. In the univariate analysis, men with BNCs had a longer length of time before drain removal (12 days vs. 6.8 days, p<0.001), which reflected urinary leakage through the vesicourethral anastomosis. In the multivariate analysis, the length of time before drain removal was the only predictor of BNC (odds ratio, 1.12; p=0.001). Intraoperative blood loss was higher in patients with BNC, but the difference was not statistically significant.
CONCLUSIONS
The most significant factor related to BNC occurrence after radical prostatectomy in our study was the length of time before drain removal, which reflects urinary leakage from the vesicourethral anastomosis. The proper formation of a watertight anastomosis to decrease urinary leakage may help to reduce the occurrence of BNC.

Keyword

Prostate neoplasms; Prostatectomy; Urinary bladder neck obstruction

MeSH Terms

Contracture
Humans
Male
Multivariate Analysis
Neck
Prevalence
Prostatectomy
Prostatic Neoplasms
Risk Factors
Urinary Bladder
Urinary Bladder Neck Obstruction

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