Early Continence and Extravasation After Open Retropubic Radical Prostatectomy – Interrupted vs Continuous Suturing for Vesicourethral Anastomosis

Early Continence and Extravasation After Open Retropubic Radical Prostatectomy – Interrupted vs Continuous Suturing for Vesicourethral Anastomosis

Nora Köhler, Nasrin El-Bandar, Andreas Maxeiner, Bernhard Ralla, Kurt Miller, Jonas Busch,* Frank Friedersdorff* Department of Urology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humbold-Universität Zu Berlin, and...

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Autores principales: Köhler N, El-Bandar N, Maxeiner A, Ralla B, Miller K, Busch J, Friedersdorff F
Formato: article
Lenguaje:EN
Publicado: Dove Medical Press 2020
Materias:
retropubic prostatectomy
vesicourethral anastomosis
suturing technique
continence
tightness
Therapeutics. Pharmacology
RM1-950
Acceso en línea:https://doaj.org/article/1476948417334b3581f86e25834c4507
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spelling oai:doaj.org-article:1476948417334b3581f86e25834c45072021-12-02T13:54:51ZEarly Continence and Extravasation After Open Retropubic Radical Prostatectomy – Interrupted vs Continuous Suturing for Vesicourethral Anastomosis1178-203Xhttps://doaj.org/article/1476948417334b3581f86e25834c45072020-12-01T00:00:00Zhttps://www.dovepress.com/early-continence-and-extravasation-after-open-retropubic-radical-prost-peer-reviewed-article-TCRMhttps://doaj.org/toc/1178-203XNora Köhler, Nasrin El-Bandar, Andreas Maxeiner, Bernhard Ralla, Kurt Miller, Jonas Busch,* Frank Friedersdorff* Department of Urology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humbold-Universität Zu Berlin, and Berlin Institute of Health, Berlin 10117, Germany*These authors contributed equally to this workCorrespondence: Frank Friedersdorff Tel +49 30 450615219Fax +49 30 450515910Email frank.friedersdorff@charite.dePurpose: To compare running suture (RS) and interrupted suture (IS) of vesicourethral anastomosis (VUA) during open retropubic radical prostatectomy (RRP) on early urinary continence and extravasation.Patients and Methods: Single center analysis of 211 patients who underwent RRP performed by a single surgeon during 2008 to 2017 was retrospectively analyzed. For VUA, we used the standard interrupted suture technique (n=100) with a 3– 0 PDS suture. The RS (n=111) was performed with 12-bite suture using 3– 0 PDS. The primary endpoints were extravasation and early continence. Demographic and peri-operative data were collected and analyzed using Pearson’s chi-square, t-Test and Mann–Whitney U-test. A binary logistic regression analysis was carried out to explore predictors that affected early continence after catheter removal.Results: The rates of early urinary incontinence (UI) were 7.7% vs 42.2% (p< 0.001). The duration of catheterization and hospitalization was significantly shorter in the interrupted group (4 days vs 5 days, p< 0.001 and 5 days vs 6 days, p< 0.001). The groups did not differ significantly in body mass index or prostate volume. There were older patients and higher PSA levels in the group with RS technique. No significant difference was found in the postoperative extravasation rates between both groups (13.5% vs 12%, p=0.742).Conclusion: Running vesicourethral anastomosis increased the rate of early urinary incontinence. Both anastomosis techniques provided a similar rate of postoperative urine extravasation. VUA should only be one of the many criteria that must be considered for the preservation of urinary continence of patients after RRP.Keywords: retropubic prostatectomy, vesicourethral anastomosis, suturing technique, continence, tightnessKöhler NEl-Bandar NMaxeiner ARalla BMiller KBusch JFriedersdorff FDove Medical Pressarticleretropubic prostatectomyvesicourethral anastomosissuturing techniquecontinencetightnessTherapeutics. PharmacologyRM1-950ENTherapeutics and Clinical Risk Management, Vol Volume 16, Pp 1289-1296 (2020)
institution DOAJ
collection DOAJ
language EN
topic retropubic prostatectomy
vesicourethral anastomosis
suturing technique
continence
tightness
Therapeutics. Pharmacology
RM1-950
spellingShingle retropubic prostatectomy
vesicourethral anastomosis
suturing technique
continence
tightness
Therapeutics. Pharmacology
RM1-950
Köhler N
El-Bandar N
Maxeiner A
Ralla B
Miller K
Busch J
Friedersdorff F
Early Continence and Extravasation After Open Retropubic Radical Prostatectomy – Interrupted vs Continuous Suturing for Vesicourethral Anastomosis
description Nora Köhler, Nasrin El-Bandar, Andreas Maxeiner, Bernhard Ralla, Kurt Miller, Jonas Busch,* Frank Friedersdorff* Department of Urology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humbold-Universität Zu Berlin, and Berlin Institute of Health, Berlin 10117, Germany*These authors contributed equally to this workCorrespondence: Frank Friedersdorff Tel +49 30 450615219Fax +49 30 450515910Email frank.friedersdorff@charite.dePurpose: To compare running suture (RS) and interrupted suture (IS) of vesicourethral anastomosis (VUA) during open retropubic radical prostatectomy (RRP) on early urinary continence and extravasation.Patients and Methods: Single center analysis of 211 patients who underwent RRP performed by a single surgeon during 2008 to 2017 was retrospectively analyzed. For VUA, we used the standard interrupted suture technique (n=100) with a 3– 0 PDS suture. The RS (n=111) was performed with 12-bite suture using 3– 0 PDS. The primary endpoints were extravasation and early continence. Demographic and peri-operative data were collected and analyzed using Pearson’s chi-square, t-Test and Mann–Whitney U-test. A binary logistic regression analysis was carried out to explore predictors that affected early continence after catheter removal.Results: The rates of early urinary incontinence (UI) were 7.7% vs 42.2% (p< 0.001). The duration of catheterization and hospitalization was significantly shorter in the interrupted group (4 days vs 5 days, p< 0.001 and 5 days vs 6 days, p< 0.001). The groups did not differ significantly in body mass index or prostate volume. There were older patients and higher PSA levels in the group with RS technique. No significant difference was found in the postoperative extravasation rates between both groups (13.5% vs 12%, p=0.742).Conclusion: Running vesicourethral anastomosis increased the rate of early urinary incontinence. Both anastomosis techniques provided a similar rate of postoperative urine extravasation. VUA should only be one of the many criteria that must be considered for the preservation of urinary continence of patients after RRP.Keywords: retropubic prostatectomy, vesicourethral anastomosis, suturing technique, continence, tightness
format article
author Köhler N
El-Bandar N
Maxeiner A
Ralla B
Miller K
Busch J
Friedersdorff F
author_facet Köhler N
El-Bandar N
Maxeiner A
Ralla B
Miller K
Busch J
Friedersdorff F
author_sort Köhler N
title Early Continence and Extravasation After Open Retropubic Radical Prostatectomy – Interrupted vs Continuous Suturing for Vesicourethral Anastomosis
title_short Early Continence and Extravasation After Open Retropubic Radical Prostatectomy – Interrupted vs Continuous Suturing for Vesicourethral Anastomosis
title_full Early Continence and Extravasation After Open Retropubic Radical Prostatectomy – Interrupted vs Continuous Suturing for Vesicourethral Anastomosis
title_fullStr Early Continence and Extravasation After Open Retropubic Radical Prostatectomy – Interrupted vs Continuous Suturing for Vesicourethral Anastomosis
title_full_unstemmed Early Continence and Extravasation After Open Retropubic Radical Prostatectomy – Interrupted vs Continuous Suturing for Vesicourethral Anastomosis
title_sort early continence and extravasation after open retropubic radical prostatectomy – interrupted vs continuous suturing for vesicourethral anastomosis
publisher Dove Medical Press
publishDate 2020
url https://doaj.org/article/1476948417334b3581f86e25834c4507
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