1106 ANASTOMOTIC STRICTURE AFTER MINI-INVASIVE RADICAL PROSTATECTOMY WITH VAN VELTHOVEN RUNNING SUTURE: INCIDENCE, PREDICTIVE FACTORS AND TREATMENT

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You have accessJournal of UrologyProstate Cancer: Localized1 Apr 20111106 ANASTOMOTIC STRICTURE AFTER MINI-INVASIVE RADICAL PROSTATECTOMY WITH VAN VELTHOVEN RUNNING SUTURE: INCIDENCE, PREDICTIVE FACTORS AND TREATMENT Idir Ouzaid, Evanguelos Xylinas, Xavier Durand, Andras Hoznek, Dimitri Vordos, Clément-Claude Abbou, Alexandre De La Taille, and Laurent Salomon Idir OuzaidIdir Ouzaid Créteil, France More articles by this author , Evanguelos XylinasEvanguelos Xylinas Créteil, France More articles by this author , Xavier DurandXavier Durand Créteil, France More articles by this author , Andras HoznekAndras Hoznek Créteil, France More articles by this author , Dimitri VordosDimitri Vordos Créteil, France More articles by this author , Clément-Claude AbbouClément-Claude Abbou Créteil, France More articles by this author , Alexandre De La TailleAlexandre De La Taille Créteil, France More articles by this author , and Laurent SalomonLaurent Salomon Créteil, France More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.2622AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The objective of this study is to evaluate the incidence and the risk factors of bladder neck contracture after mini invasive radical prostatectomy with Van Velthoven single kont running suture for the vesico-urethral anastomosis. METHODS From 1998 to 2010, 2115 patients underwent extraperitoneal, transperitoneal or robotic assisted radical prosatatectomy for localized prostate cancer. A single knot running suture according to the Van Velthoven technique was used for the vesico-urethral anastomosis. Follow-up was scheduled and standarized for all patients and recorded into a prospective database. Mean follow-up was 43 (6–144) months. All prostatectomies were performed by three surgeons in our departement. Bladder neck contracture was defined by a reduction of the lumen that does not allow the passage of a 18 French fibroscope. RESULTS Among the selected patients,1342, 241 and 532 had extraperitoneal, tranperitoneal and robotic assisted prostatectomy repsectively. After 43months follow-up, the incidence of bladder neck contracture was 1.4%. Seventy eight per cent of the bladder neck contractures were diagnosed within the first year of follow-up On univariate analysis, hospital stay more than 8 days (p=0.02), a prior TURP before RP (p=0.04), external beam radiotherapy after surgery (p=0.001) were significant predictive risk factors for BNC. Laparoscopic approach showed more BNC than robotic assisted surgery (p=0.02). Neither the BMI nor the blood loss during surgery showed any differences between the 2 groups. On multivariate analysis only a prior TURP to RP (p=0.04) and external beam radiotherapy after the RP (p=0.007) were statistically significant. During the follow-up period, the number of surgical procedure per patient was 2.4. The cumulative success rate was 90 %. The success rate after one cold-knife urethrotomy procedure was 47% and rose up to 64% after a second procedure. Eight patients needed more than 2 procedures to be healed. In 3 (10 %) patients the treatment failed. CONCLUSIONS Bladder neck contracture incidence after mini invasive radical prostatectomy using the single knot running suture fort he vesico-urethral anastomosis is low. Prior TURP and external beam radiotherapy are risk factors. The treamtent is life consuming and repeated procedures are necessery to achieve a satisfying result. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e444-e445 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Idir Ouzaid Créteil, France More articles by this author Evanguelos Xylinas Créteil, France More articles by this author Xavier Durand Créteil, France More art