Introduction and Objectives
Strictures on vesicourethral anastomosis(VUA) after laparoscopic radical prostatectomies(LRP) are relatively common complication. Beside prolonged extravasation on anastomosis, operations on prostate or bladder neck, which were done before radical prostatectomy, as risc factors for strictures on VUA, we think that meticulous preparation on bladder neck and apex of prostate as much as technique of anastomotic sutturing, are major factors for prevention of strictures on anastomosis.
Material and Methods
733 patients with prostate carcinoma were operated between Years 2004 and 2009. Follow up was at 1, 3, 6, 12, 18 and 24 month. Strictures were diagnosed urethrocystoscopically. When the stricture was diagnosed, it was resolved with incision, transurethral resection (TUR) or with open reconstructions of anastomosis. Method selection depended of length and degree of stricture.
Results
After median time of 5.8 months, we diagnosed stricture on VUA in 18 patients (2.2%). We founded that prolonged extravasation and operative technique of preparation of bladder neck, apex and construction of VUA, are major factors for prevention of stricture. Incision on anastomosis was performed in 15 patient, in 2 patients we did TUR and in one patient we had to do done open reconstruction.
Conclusions
Preparation of bladder neck and apex, as much as construction of anastomosis are very important risc factors for preventions of stricture on VUA. Good operative technique and maintaining maximal concentration during the whole procedure is crucial.
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Copyright
© 2009 European Association of Urology. Published by Elsevier Inc. All rights reserved.
