title: [Transrectal ultrasonography in the assessment of patients after radical prostatectomy. Normal and pathologic ultrasonography anatomy of vesico-urethral anastomosis].
abstract: OBJECTIVE
  To determine the ultrasound characteristics of the vesico-urethral anastomotic complex in patients with radical prostatectomy to separate normal prostate fossae from those affected by local recurrence or residual tumour.
  
  
  METHODS
  Between January 1998 and June 1999 15 ultrasound guided transrectal biopsies of vesico-urethral anastomosis or prostate fossae were performed in patients with radical prostatectomy. The selection criteria to perform puncture in these patients were a negative extension study (abdominal-pelvic CT and bone scan), PSA higher than 0.4 ng/mL and/or suspicious DRE. The study was completed with 10 transrectal ultrasound (TRU) after radical prostatectomy in patients with normal PSA and DRE. TRU parameters in patients with tumour-positive biopsies were compare to those from patients with negative biopsies and those obtained from TRU in patients with both normal PSA and normal DRE.
  
  
  RESULTS
  The ultrasound parameters that best described prostate fossa abnormalities were the presence of hypoechoic masses or nodes and the integrity or not of the retro-anastomotic fat layer. When a hypoechoic mass or node was found at the anastomosis level, 80% biopsies were positive for tumour local recurrence. The percentage increases when changes are seen at the retro-anastomotic fat layer.
  
  
  CONCLUSIONS
  In spite of a good correlation between ultrasound abnormalities and positive biopsies, ultrasound findings from the vesico-urethral anastomosis in patients with radical prostatectomy are not well defined. Nodes or ultrasound irregularities can exist in normal prostate fossae as well as normal anastomosis ultrasound in the presence of tumoral relapses. We believe TRU of vesico-urethral anastomosis to be the best method available to evaluate local recurrence or tumoral persistence after radical prostatectomy.
authors.affiliation: Servicio de Urología, Hospital Universitario de Puerto Real, Cádiz.
authors.forename: C
authors.initials: C
authors.lastname: Varo Solís
authors.forename: J
authors.initials: J
authors.lastname: Bachiller Burgos
authors.forename: M
authors.initials: M
authors.lastname: Soto Delgado
authors.forename: V
authors.initials: V
authors.lastname: Beltrán Aguilar
authors.forename: F
authors.initials: F
authors.lastname: Estudillo González
mesh_terms: D000714:Anastomosis, Surgical; D006801:Humans; D011182:Postoperative Care; D011468:Prostatectomy; D012007:Rectum; D014463:Ultrasonography / Q000379:methods; D014521:Urethra / Q000000981:diagnostic imaging* / Q000601:surgery*; D001743:Urinary Bladder / Q000000981:diagnostic imaging* / Q000601:surgery*