Yeungnam Univ J Med.  2021 Apr;38(2):142-147. 10.12701/yujm.2020.00682.

Association between cystographic anastomotic urinary leakage following retropubic radical prostatectomy and early urinary incontinence

• Kwon SY

• KMID: 2515188
• DOI: http://doi.org/10.12701/yujm.2020.00682

Abstract

Background
This study was performed to investigate the association between cystographic anastomotic urinary leakage (UL) after radical retropubic prostatectomy (RRP) and early urinary incontinence (UI).
Methods
The medical records of 53 patients who had undergone cystography after RRP at our institution between January 2015 and December 2018 were retrospectively analyzed. Cystography was performed 7 to 10 days after surgery. The duration of catheterization depended on the degree of UL, which was classified as mild, moderate, or severe. The study subjects were divided into the non-UL group and the UL group. Continence was defined as the use of no pads. The prostate was dissected in an antegrade fashion, and urethrovesical anastomosis was performed with a continuous suture.
Results
Incontinence rates at 1 and 3 months postoperatively were significantly higher in the UL group than the non-UL group (83.3% vs. 52.2%, p=0.014 and 76.7% vs. 47.8%, p=0.030, respectively); however, those at 6 and 12 months were not significantly different (23.3% vs. 17.4%, p=0.597 and 4.3% vs. 10.0%, p=0.440, respectively). The presence of cystographic anastomotic UL was found to be predictive of UI during the first 3 postoperative months (odds ratio, 3.3; p=0.045). The continence rates during the first 3 postoperative month continence rate showed significant difference with non-UL group regardless of the degree of UL.
Conclusion
The presence of anastomotic UL on cystography was associated with higher rates of UI in the early postoperative period, however the grade of UL was not related to the late recovery of UI. Incontinence rates in patients with or without anastomotic UL immediately after RRP equalized at 6 months.

Keyword

Anastomotic urinary leakage; Radical prostatectomy; Urinary incontinence

Figure

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  Fig. 1. Cystography findings and classification of urinary leakage (UL). (A) Mild UL (UL developed after bladder filling with 200 mL normal saline). (B) Moderate UL (UL developed after bladder filling with 100 mL normal saline). (C) Severe UL (UL developed before bladder filling with 100 mL normal saline).

Reference

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