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Early Continence and Extravasation After Open Retropubic Radical Prostatectomy – Interrupted vs Continuous Suturing for Vesicourethral Anastomosis

PURPOSE: To compare running suture (RS) and interrupted suture (IS) of vesicourethral anastomosis (VUA) during open retropubic radical prostatectomy (RRP) on early urinary continence and extravasation. PATIENTS AND METHODS: Single center analysis of 211 patients who underwent RRP performed by a sing...

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Autores principales: Köhler, Nora, El-Bandar, Nasrin, Maxeiner, Andreas, Ralla, Bernhard, Miller, Kurt, Busch, Jonas, Friedersdorff, Frank
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove 2020
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Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7767697/
https://www.ncbi.nlm.nih.gov/pubmed/33380800
http://dx.doi.org/10.2147/TCRM.S278454
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author Köhler, Nora
El-Bandar, Nasrin
Maxeiner, Andreas
Ralla, Bernhard
Miller, Kurt
Busch, Jonas
Friedersdorff, Frank
author_facet Köhler, Nora
El-Bandar, Nasrin
Maxeiner, Andreas
Ralla, Bernhard
Miller, Kurt
Busch, Jonas
Friedersdorff, Frank
author_sort Köhler, Nora
collection PubMed
description PURPOSE: To compare running suture (RS) and interrupted suture (IS) of vesicourethral anastomosis (VUA) during open retropubic radical prostatectomy (RRP) on early urinary continence and extravasation. PATIENTS AND METHODS: Single center analysis of 211 patients who underwent RRP performed by a single surgeon during 2008 to 2017 was retrospectively analyzed. For VUA, we used the standard interrupted suture technique (n=100) with a 3–0 PDS suture. The RS (n=111) was performed with 12-bite suture using 3–0 PDS. The primary endpoints were extravasation and early continence. Demographic and peri-operative data were collected and analyzed using Pearson’s chi-square, t-Test and Mann–Whitney U-test. A binary logistic regression analysis was carried out to explore predictors that affected early continence after catheter removal. RESULTS: The rates of early urinary incontinence (UI) were 7.7% vs 42.2% (p<0.001). The duration of catheterization and hospitalization was significantly shorter in the interrupted group (4 days vs 5 days, p<0.001 and 5 days vs 6 days, p<0.001). The groups did not differ significantly in body mass index or prostate volume. There were older patients and higher PSA levels in the group with RS technique. No significant difference was found in the postoperative extravasation rates between both groups (13.5% vs 12%, p=0.742). CONCLUSION: Running vesicourethral anastomosis increased the rate of early urinary incontinence. Both anastomosis techniques provided a similar rate of postoperative urine extravasation. VUA should only be one of the many criteria that must be considered for the preservation of urinary continence of patients after RRP.
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spelling pubmed-77676972020-12-29 Early Continence and Extravasation After Open Retropubic Radical Prostatectomy – Interrupted vs Continuous Suturing for Vesicourethral Anastomosis Köhler, Nora El-Bandar, Nasrin Maxeiner, Andreas Ralla, Bernhard Miller, Kurt Busch, Jonas Friedersdorff, Frank Ther Clin Risk Manag Original Research PURPOSE: To compare running suture (RS) and interrupted suture (IS) of vesicourethral anastomosis (VUA) during open retropubic radical prostatectomy (RRP) on early urinary continence and extravasation. PATIENTS AND METHODS: Single center analysis of 211 patients who underwent RRP performed by a single surgeon during 2008 to 2017 was retrospectively analyzed. For VUA, we used the standard interrupted suture technique (n=100) with a 3–0 PDS suture. The RS (n=111) was performed with 12-bite suture using 3–0 PDS. The primary endpoints were extravasation and early continence. Demographic and peri-operative data were collected and analyzed using Pearson’s chi-square, t-Test and Mann–Whitney U-test. A binary logistic regression analysis was carried out to explore predictors that affected early continence after catheter removal. RESULTS: The rates of early urinary incontinence (UI) were 7.7% vs 42.2% (p<0.001). The duration of catheterization and hospitalization was significantly shorter in the interrupted group (4 days vs 5 days, p<0.001 and 5 days vs 6 days, p<0.001). The groups did not differ significantly in body mass index or prostate volume. There were older patients and higher PSA levels in the group with RS technique. No significant difference was found in the postoperative extravasation rates between both groups (13.5% vs 12%, p=0.742). CONCLUSION: Running vesicourethral anastomosis increased the rate of early urinary incontinence. Both anastomosis techniques provided a similar rate of postoperative urine extravasation. VUA should only be one of the many criteria that must be considered for the preservation of urinary continence of patients after RRP. Dove 2020-12-23 /pmc/articles/PMC7767697/ /pubmed/33380800 http://dx.doi.org/10.2147/TCRM.S278454 Text en © 2020 Köhler et al. http://creativecommons.org/licenses/by-nc/3.0/ This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
spellingShingle Original Research
Köhler, Nora
El-Bandar, Nasrin
Maxeiner, Andreas
Ralla, Bernhard
Miller, Kurt
Busch, Jonas
Friedersdorff, Frank
Early Continence and Extravasation After Open Retropubic Radical Prostatectomy – Interrupted vs Continuous Suturing for Vesicourethral Anastomosis
title Early Continence and Extravasation After Open Retropubic Radical Prostatectomy – Interrupted vs Continuous Suturing for Vesicourethral Anastomosis
title_full Early Continence and Extravasation After Open Retropubic Radical Prostatectomy – Interrupted vs Continuous Suturing for Vesicourethral Anastomosis
title_fullStr Early Continence and Extravasation After Open Retropubic Radical Prostatectomy – Interrupted vs Continuous Suturing for Vesicourethral Anastomosis
title_full_unstemmed Early Continence and Extravasation After Open Retropubic Radical Prostatectomy – Interrupted vs Continuous Suturing for Vesicourethral Anastomosis
title_short Early Continence and Extravasation After Open Retropubic Radical Prostatectomy – Interrupted vs Continuous Suturing for Vesicourethral Anastomosis
title_sort early continence and extravasation after open retropubic radical prostatectomy – interrupted vs continuous suturing for vesicourethral anastomosis
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7767697/
https://www.ncbi.nlm.nih.gov/pubmed/33380800
http://dx.doi.org/10.2147/TCRM.S278454
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