Korean J Urol.  2015 Jun;56(6):443-448. 10.4111/kju.2015.56.6.443.

Comparison of perioperative outcomes between running versus interrupted vesicourethral anastomosis in open radical prostatectomy: A single-surgeon experience

• Lim JH
• Park CM
• Kim HK
• Park JY

• KMID: 2160584
• DOI: http://doi.org/10.4111/kju.2015.56.6.443

Abstract

PURPOSE
To compare perioperative outcomes between running and interrupted vesicourethral anastomosis in open radical prostatectomy (RP).
MATERIALS AND METHODS
The medical records of 112 patients who underwent open RP for prostate cancer at our institution from 2006 to 2008 by a single surgeon were retrospectively reviewed. Preoperative, intraoperative, and postoperative parameters were measured.
RESULTS
Of 112 consecutive patients, 62 patients underwent vesicourethral anastomosis by use of the running technique, whereas 50 patients underwent anastomosis with the interrupted technique. The groups did not differ significantly in age, body mass index, prostate-specific antigen, prostate volume, or pathologic findings. The intraoperative extravasation rate was significantly lower in the running group (8.1% vs. 24.0%, p=0.01). The mean anastomosis time was 15.1+/-5.3 and 19.3+/-4.6 minutes in the running and interrupted groups, respectively (p=0.04). The rates of postoperative extravasation were similar for both groups (6.4% vs. 10.0%, p=0.12). The duration of catheterization was significantly shorter in the running group (9.0+/-3.0 days vs. 12.9+/-6.4 days, p<0.01). The rate of urinary retention after catheter removal and the rate of bladder neck contracture were not significantly different between the two groups. The rate of urinary continence at 3, 6, 9, and 12 months after RP was also similar in both groups.
CONCLUSIONS
Both anastomosis techniques provided similar functional results and a similar rate of postoperative urine extravasation. However, running vesicourethral anastomosis decreased the rate of intraoperative extravasation and time for anastomosis, without increasing the risk of urinary retention or bladder neck contracture.

Keyword

Prostatectomy; Prostatic neoplasms; Surgical anastomosis; Urine

MeSH Terms

Aged
Anastomosis, Surgical/methods
Follow-Up Studies
Humans
Male
Middle Aged
Neoplasm Staging
Prostatectomy/adverse effects/*methods
Prostatic Neoplasms/pathology/*surgery
Retrospective Studies
Suture Techniques
Treatment Outcome
Urethra/*surgery
Urinary Bladder/*surgery
Urinary Incontinence/etiology/prevention & control
Urinary Retention/etiology

Figure

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  Fig. 1 (A-E) Schematic diagram for running vesicourethral anastomosis technique using nephrostomy catheter.

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