PTU - Polskie Towarzystwo Urologiczne
home page
current numbers
archival numbers
list of articles:
list przewodni/covering letter
editor
Scientific Committee
publisher
subscription
advertising
important links

CYSTOGRAPHIC ASSESSMENT OF THE VESICOURETHRAL ANASTOMOSIS AFTER RADICAL PROSTATECTOMY
Article published in Urologia Polska 2000/53/1.

authors

Tomasz Demkow, Tomasz Wi¶niewski
Klinika Nowotworów Układu Moczowego Instytutu Onkologii w Warszawie
p.o. Kierownika Kliniki: dr n. med. T. Demkow

keywords

prostate radical prostatectomy vesicourethral junction integrity cystography

summary

Objectives. Cystography is obtained routinely after radical retropubic
prostatectomy to assess the integrity of the vesicourethral anastomosis before
removal of the catheter.
Methods. The results of cystography, performed in a period of 7 to 14 days
post radical prostatectomy, were retrospectively reviewed in 59 cases.
Results. After mean postoperative day 11 ? 2,5 range (7-22 days) cystograms
were performed. No or minimal extravasation were found in 93.2% patients.
The presence of a minimal contrast extravasation did not affect outcome after
removal of the catheter. After mean 5.6 ? 10.2 months (range 1-42 months) the
stricure of the vesicosurethral anastomosis has not been found. Following
catheter removal there was no urinary retention.
Conclusions. Cystographic confirmation of anastomotic integrity before
removal of the catheter following 7-14 days of catheterisation is not indicated
in the routine postradical prostatectomy patients.

references

  1. [1] Berlin, J. W., Ramchandani, R, Banner, M. P., Pollack, H. M., Nodine,
  2. CR, Wein, A. J.: Voiding cystography after radical prostatectomy: normal find-
  3. ings and correlation between contrast extravasation and anastomotic strictures. Am.
  4. J. Roentgenol. 1994,162, 87-91.
  5. [2] Dalton, D. R, Schaeffer, A. }., Garnett, J. E., Grayhack, J. T.; Radio-
  6. graphic assessment of the vesicourethral anastomosis directing early decatheteriza-
  7. tion following nerue sparing radical retropubic prostatectomy. J. Urol. 1989, 141,
  8. 79-81.
  9. [3] Igel, T. C, Barrett, D. M., Segura, J. W., Benson, R. C, Rife, C. C:
  10. Perioperative and postoperative complications from bilateral pelvic lymphadenec-
  11. tomy and radical reteropubic prostatectomy. J. Urol. 1987,137,1189-1191.
  12. [4] Koch, M. O., Smith, J. A., Hodge, E. M., Brandell, R. A.: Prospectwe
  13. development of costefficient program for radical retropubic prostatectomy. Urology
  14. 1994, 44, 311-318.
  15. [5] Leibovitch, I., Randall, G., Little, J. S., Foster, R. S? Bihrle, R., Donohoue,
  16. J. P.: Cystography after radical retropubic prostatectomy: clinical implications of
  17. abnormal findings. Urology 1995, 46, 78-80.
  18. [6] 0evy, J. B., Ramchandani, R, Berlin, J. W., Broderick, G. A., Wein, A.J.:
  19. Vesicourethral healing following radical prostatectomy: is it related to surgical ap-
  20. proach? Urology 1994, 44, 6, 888-892.
  21. [7] Licht, M. R., Klein, E. A.: Early hospital discharge after radical retropubic pros-
  22. tatectomy impact on cost and complication rate. Urology 1994, 44, 700-704.
  23. [8] Little, S. J., Bichrle, R., Foster, R.: Early urethral catheter removal following
  24. radical prostatectomy: a pilot study. Urology 1995, 46, 429-431.
  25. [9] Popken, G., Sommerkamp, H., Schulze-Seemann, W., Wetterauer, U.,
  26. Katzenwadel, A.: Anastomotic stricture after radical prostatectomy. Eur. Urol.
  27. 1998, 33, 382-386.
  28. [10] Schatzl, G., Madersbacher, S., Hofbauer, J., Pycha, A., Reiter, W. J.,
  29. Svolba, G., Marberger, M.: The impact of urinary extravasation after radical
  30. retropubic prostatectomy on urinary incontinence and anastomotic stricture. Eur.
  31. Urol. 1999, 36,187-190.
  32. [11] Surya, B. V., Provet, J., Johanson, K. E., Brown, J.: Anastomotic strictures
  33. following radical retropubic prostatectomy: risk factors and management. J. Urol.
  34. 1990,143, 755-758.