Русский
Two-layer posterior reconstruction of the vesicourethral anastomosis during robotic-assisted radical prostatectomy
DOI: https://dx.doi.org/10.18565/urology.2021.3.82-86
M.A. Kodzokov, E.V. Spot, A.V. Proskura, E.S. Gazimiev, A.D. Damiev, M.A. Gazimiev
Institute for Urology and Human Reproductive Health of I.M. Sechenov First Moscow State Medical University, Moscow, Russia
Aim. To study the influence of the technique of posterior reconstruction of the vesicourethral anastomosis (VUA) on the prevention of urinary incontinence after robotic-assisted radical prostatectomy (RARP).
Material and methods. A total of 67 patients (mean age 63 years) with localized prostate cancer were included in the study. All patients were divided into two groups. In the group 1 (n=32) the standard technique of the VUA was used, while in the group 2 (n=35) the two-layer posterior reconstruction was done. The impact of urinary incontinence on the quality of life was analyzed using the ICIQ-SF questionnaire 1, 3 and 6 months after operation. On postoperative days 5–7, all patients underwent cystography to assess the tightness of the VUA.
Results. One month after RARP in the group 1 the mean score of ICIQ-SF questionnaire was 6.72, compared to 4.57 in group 2 (p=0.04). After 3 and 6 months the respective values were 3.8 vs. 2.3 (p=0.09) and 1.94 vs. 1.2 (p=0.23), respectively. Cystography revealed no extravasation of the contrast.
Conclusion. The results of a retrospective comparative study suggest that a two-layer posterior reconstruction of the VUA during RARP, being a simple method, provides better continence rate one month postoperatively compared to standard technique, although larger randomized clinical trials are needed.
Material and methods. A total of 67 patients (mean age 63 years) with localized prostate cancer were included in the study. All patients were divided into two groups. In the group 1 (n=32) the standard technique of the VUA was used, while in the group 2 (n=35) the two-layer posterior reconstruction was done. The impact of urinary incontinence on the quality of life was analyzed using the ICIQ-SF questionnaire 1, 3 and 6 months after operation. On postoperative days 5–7, all patients underwent cystography to assess the tightness of the VUA.
Results. One month after RARP in the group 1 the mean score of ICIQ-SF questionnaire was 6.72, compared to 4.57 in group 2 (p=0.04). After 3 and 6 months the respective values were 3.8 vs. 2.3 (p=0.09) and 1.94 vs. 1.2 (p=0.23), respectively. Cystography revealed no extravasation of the contrast.
Conclusion. The results of a retrospective comparative study suggest that a two-layer posterior reconstruction of the VUA during RARP, being a simple method, provides better continence rate one month postoperatively compared to standard technique, although larger randomized clinical trials are needed.
About the Autors
Corresponding author: M.A. Kodzokov – 3-year Ph.D. student, Institute for Urology and Human Reproductive Health of I.M. Sechenov First Moscow State Medical University, Moscow, Russia; e-mail: Kodzokov-m@mail.ru
Similar Articles
