Initial results using a running vesicourethral anastomosis following open radical retropubic prostatectomy.
OBJECTIVE
We assessed the results of early catheter removal following radical prostatectomy using a continuous suture vesicourethral anastomosis.


METHODS
From March 2001 through December 2003, 76 patients underwent open radical prostatectomy, as performed by a single surgeon. A continuous 3-zero polyglactin suture was used for the vesicourethral anastomosis in 72 patients. Drain fluid creatinine on postoperative day 1 was used to assess anastomotic leakage. A cystogram was done before catheter removal in the initial 25 patients. Subsequently a cystogram was performed only if there was suspicion of urine leakage.


RESULTS
Early catheter removal was possible in 63 of 72 patients (88%). Catheter removal occurred a mean of 3.4 days (range 1 to 6) postoperatively in this group. Ten of the 14 men who required catheter reinsertion for urinary retention had the catheter removed before postoperative day 4. In the remaining 9 patients early catheter removal was not attempted. Catheter removal occurred a mean of 10.1 days (range 7 to 14) postoperatively in this group. Overall the urethral catheter was successfully removed on or before postoperative day 6 (range 1 to 6) in 78% of patients. There was no incidence of urinoma, pelvic abscess or bladder neck contracture at a mean followup of 31 months (range 2 to 46).


CONCLUSIONS
A running vesicourethral anastomosis following open radical retropubic prostatectomy allows reliable early catheter removal by postoperative days 4 to 6 in most patients with no increase in morbidity.
Harpster
Lewis E
LE
Division of Urology, Milton S. Hershey Medical Center, Pennsylvania State University, Hershey, Pennsylvania 17033, USA.
Brien
James
J
D000368:Aged; D000714:Anastomosis, Surgical; D006801:Humans; D008297:Male; D008875:Middle Aged; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000601:surgery*; D014521:Urethra / Q000601:surgery; D001743:Urinary Bladder / Q000601:surgery*; D014546:Urinary Catheterization