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Fossa Navicularis Strictures Due to 22F Catheters Used in Robotic Radical Prostatectomy
BACKGROUND AND OBJECTIVES: Fossa navicularis strictures following radical prostatectomy are reported infrequently. We recently experienced a series of fossa strictures following robot-assisted laparoscopic radical prostatectomy. Fossa strictures are usually procedure-induced, arising from urethral t...
Autores principales: | , , , |
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Formato: | Texto |
Lenguaje: | English |
Publicado: |
Society of Laparoendoscopic Surgeons
2007
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3015838/ https://www.ncbi.nlm.nih.gov/pubmed/17931514 |
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author | Yee, David S. Ahlering, Thomas E. Gelman, Joel Skarecky, Douglas W. |
author_facet | Yee, David S. Ahlering, Thomas E. Gelman, Joel Skarecky, Douglas W. |
author_sort | Yee, David S. |
collection | PubMed |
description | BACKGROUND AND OBJECTIVES: Fossa navicularis strictures following radical prostatectomy are reported infrequently. We recently experienced a series of fossa strictures following robot-assisted laparoscopic radical prostatectomy. Fossa strictures are usually procedure-induced, arising from urethral trauma or infection; catheter size has not been reported as a factor. We describe herein our experience to determine and prevent fossa navicularis stricture development. METHODS: From June 2002 until February 2005, 248 patients underwent robot-assisted laparoscopic prostatectomy with the da Vinci surgical system at our institution. Fossa strictures were diagnosed based on acute onset of obstructive voiding symptoms, IPSS and flow pattern changes, and bougie calibration. During our series, we switched from an 18F to a 22F catheter to avoid inadvertent stapling of the urethra when dividing the dorsal venous complex. All patients had an 18F catheter placed after the anastomosis for 1 week. Parameters were evaluated using Fisher's exact test and the Student t test for means. RESULTS: The 18F catheter group (n=117) developed 1 fossa stricture, whereas the 22F catheter group (n=131) developed 9 fossa strictures (P=0.02). The fossa stricture rate in the 18F group was 0.9% versus 6.9% in the 22F group. The 2 groups had no differences in age, body mass index, cardiovascular disease, International Prostate Symptom Score, urinary bother score, SHIM score, preoperative PSA, operative time, estimated blood loss, cautery use, prostate size, or catheterization time. CONCLUSIONS: Using a larger urethral catheter size during intraoperative dissection appears to increase the risk 8-fold for fossa stricture as compared with the 18F catheter. The pneumoperitoneum and prolonged extreme Trendelenberg position could potentially contribute to local urethral ischemia. |
format | Text |
id | pubmed-3015838 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2007 |
publisher | Society of Laparoendoscopic Surgeons |
record_format | MEDLINE/PubMed |
spelling | pubmed-30158382011-02-17 Fossa Navicularis Strictures Due to 22F Catheters Used in Robotic Radical Prostatectomy Yee, David S. Ahlering, Thomas E. Gelman, Joel Skarecky, Douglas W. JSLS Scientific Papers BACKGROUND AND OBJECTIVES: Fossa navicularis strictures following radical prostatectomy are reported infrequently. We recently experienced a series of fossa strictures following robot-assisted laparoscopic radical prostatectomy. Fossa strictures are usually procedure-induced, arising from urethral trauma or infection; catheter size has not been reported as a factor. We describe herein our experience to determine and prevent fossa navicularis stricture development. METHODS: From June 2002 until February 2005, 248 patients underwent robot-assisted laparoscopic prostatectomy with the da Vinci surgical system at our institution. Fossa strictures were diagnosed based on acute onset of obstructive voiding symptoms, IPSS and flow pattern changes, and bougie calibration. During our series, we switched from an 18F to a 22F catheter to avoid inadvertent stapling of the urethra when dividing the dorsal venous complex. All patients had an 18F catheter placed after the anastomosis for 1 week. Parameters were evaluated using Fisher's exact test and the Student t test for means. RESULTS: The 18F catheter group (n=117) developed 1 fossa stricture, whereas the 22F catheter group (n=131) developed 9 fossa strictures (P=0.02). The fossa stricture rate in the 18F group was 0.9% versus 6.9% in the 22F group. The 2 groups had no differences in age, body mass index, cardiovascular disease, International Prostate Symptom Score, urinary bother score, SHIM score, preoperative PSA, operative time, estimated blood loss, cautery use, prostate size, or catheterization time. CONCLUSIONS: Using a larger urethral catheter size during intraoperative dissection appears to increase the risk 8-fold for fossa stricture as compared with the 18F catheter. The pneumoperitoneum and prolonged extreme Trendelenberg position could potentially contribute to local urethral ischemia. Society of Laparoendoscopic Surgeons 2007 /pmc/articles/PMC3015838/ /pubmed/17931514 Text en © 2007 by JSLS, Journal of the Society of Laparoendoscopic Surgeons. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License (http://creativecommons.org/licenses/by-nc-nd/3.0/), which permits for noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited and is not altered in any way. |
spellingShingle | Scientific Papers Yee, David S. Ahlering, Thomas E. Gelman, Joel Skarecky, Douglas W. Fossa Navicularis Strictures Due to 22F Catheters Used in Robotic Radical Prostatectomy |
title | Fossa Navicularis Strictures Due to 22F Catheters Used in Robotic Radical Prostatectomy |
title_full | Fossa Navicularis Strictures Due to 22F Catheters Used in Robotic Radical Prostatectomy |
title_fullStr | Fossa Navicularis Strictures Due to 22F Catheters Used in Robotic Radical Prostatectomy |
title_full_unstemmed | Fossa Navicularis Strictures Due to 22F Catheters Used in Robotic Radical Prostatectomy |
title_short | Fossa Navicularis Strictures Due to 22F Catheters Used in Robotic Radical Prostatectomy |
title_sort | fossa navicularis strictures due to 22f catheters used in robotic radical prostatectomy |
topic | Scientific Papers |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3015838/ https://www.ncbi.nlm.nih.gov/pubmed/17931514 |
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