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A new technique of bladder neck reconstruction during radical prostatectomy in patients with prostate cancer

PURPOSE: To evaluate continence after radical prostatectomy in prostate cancer patients, in whom a new method of the bladder neck reconstruction (BNR) using deep dorsal stitch was implemented (deep single stitch through all bladder layers directly dorsal to the bladder opening after “tennis racket”...

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Autores principales: Tolkach, Yuri, Godin, Konstantin, Petrov, Sergey, Schelin, Sonny, Imkamp, Florian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Sociedade Brasileira de Urologia 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4752138/
https://www.ncbi.nlm.nih.gov/pubmed/26200563
http://dx.doi.org/10.1590/S1677-5538.IBJU.2014.0341
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author Tolkach, Yuri
Godin, Konstantin
Petrov, Sergey
Schelin, Sonny
Imkamp, Florian
author_facet Tolkach, Yuri
Godin, Konstantin
Petrov, Sergey
Schelin, Sonny
Imkamp, Florian
author_sort Tolkach, Yuri
collection PubMed
description PURPOSE: To evaluate continence after radical prostatectomy in prostate cancer patients, in whom a new method of the bladder neck reconstruction (BNR) using deep dorsal stitch was implemented (deep single stitch through all bladder layers directly dorsal to the bladder opening after “tennis racket” reconstruction) and to provide justification for its use by means of anatomical study in cadavers. MATERIAL AND METHODS: Open radical retropubic prostatectomy was performed in 84 patients: 39 patients with a new BNR method used to improve continence and control group of 45 patients with standard “tennis racket” BNR. Median follow-up was 14 months in control group and 12 months in study group. Continence recovery was accessed early postoperatively and every 3 months thereafter. Anatomical study was performed on 2 male fresh cadavers reproducing two different BNR techniques to clarify any underlying continence related mechanisms. RESULTS: Patients with new BNR achieved full continence significantly faster (p=0.041), but the continence rates after 12 months were similar between groups. The severity of incontinence up to month 9 was significantly reduced in BNR group. The anastomotic stricture rate was not affected. Applying new BNR to the cadaver model revealed effects on early continence, namely presence of proximal passive closure mechanism in area of bladder neck. CONCLUSIONS: Continence in patients with the new BNR method using deep dorsal stitch recovered significantly faster. Moreover, a reduced grade of residual incontinence was documented. The effect was non-significant at month 12 of follow-up, meaning that only early effect was present.
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spelling pubmed-47521382016-05-09 A new technique of bladder neck reconstruction during radical prostatectomy in patients with prostate cancer Tolkach, Yuri Godin, Konstantin Petrov, Sergey Schelin, Sonny Imkamp, Florian Int Braz J Urol Original Article PURPOSE: To evaluate continence after radical prostatectomy in prostate cancer patients, in whom a new method of the bladder neck reconstruction (BNR) using deep dorsal stitch was implemented (deep single stitch through all bladder layers directly dorsal to the bladder opening after “tennis racket” reconstruction) and to provide justification for its use by means of anatomical study in cadavers. MATERIAL AND METHODS: Open radical retropubic prostatectomy was performed in 84 patients: 39 patients with a new BNR method used to improve continence and control group of 45 patients with standard “tennis racket” BNR. Median follow-up was 14 months in control group and 12 months in study group. Continence recovery was accessed early postoperatively and every 3 months thereafter. Anatomical study was performed on 2 male fresh cadavers reproducing two different BNR techniques to clarify any underlying continence related mechanisms. RESULTS: Patients with new BNR achieved full continence significantly faster (p=0.041), but the continence rates after 12 months were similar between groups. The severity of incontinence up to month 9 was significantly reduced in BNR group. The anastomotic stricture rate was not affected. Applying new BNR to the cadaver model revealed effects on early continence, namely presence of proximal passive closure mechanism in area of bladder neck. CONCLUSIONS: Continence in patients with the new BNR method using deep dorsal stitch recovered significantly faster. Moreover, a reduced grade of residual incontinence was documented. The effect was non-significant at month 12 of follow-up, meaning that only early effect was present. Sociedade Brasileira de Urologia 2015-05-01 /pmc/articles/PMC4752138/ /pubmed/26200563 http://dx.doi.org/10.1590/S1677-5538.IBJU.2014.0341 Text en https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Tolkach, Yuri
Godin, Konstantin
Petrov, Sergey
Schelin, Sonny
Imkamp, Florian
A new technique of bladder neck reconstruction during radical prostatectomy in patients with prostate cancer
title A new technique of bladder neck reconstruction during radical prostatectomy in patients with prostate cancer
title_full A new technique of bladder neck reconstruction during radical prostatectomy in patients with prostate cancer
title_fullStr A new technique of bladder neck reconstruction during radical prostatectomy in patients with prostate cancer
title_full_unstemmed A new technique of bladder neck reconstruction during radical prostatectomy in patients with prostate cancer
title_short A new technique of bladder neck reconstruction during radical prostatectomy in patients with prostate cancer
title_sort new technique of bladder neck reconstruction during radical prostatectomy in patients with prostate cancer
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4752138/
https://www.ncbi.nlm.nih.gov/pubmed/26200563
http://dx.doi.org/10.1590/S1677-5538.IBJU.2014.0341
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