Vesicourethral anastomosis during radical retropubic prostatectomy: does the number of sutures matter?
OBJECTIVE
To prospectively evaluate the outcome of radical retropubic prostatectomy using three different techniques of vesicourethral anastomosis (VUA), with a different number of sutures used during this surgical step.


METHODS
Three groups of patients who had undergone nerve-sparing radical retropubic prostatectomy were compared. Overall, 90 patients with localized prostate cancer were recruited. The patients were randomly assigned to undergo one of three different VUA techniques. The anastomotic sutures consisted of four or six monocryl 2-0 stitches. The "two-suture" anastomosis in group 1 was performed by passing two U-shaped horizontal stitches at the 6-o'clock and 12-o'clock positions. The following intraoperative and perioperative parameters were considered for the comparative analysis: time to perform VUA, blood loss, hospitalization, and time to drain removal.


RESULTS
A statistically significant difference was found in terms of the mean time to anastomosis between groups 1 and 2 (3.61 +/- 1.14 versus 16.6 +/- 4.04, P <0.0001) and between groups 1 and 3 (3.61 +/- 1.14 versus 23.45 +/- 5.4, P <0.0001). No significant differences could be detected for blood loss, time to drain removal, or hospitalization. No significant difference was detected in terms of functional outcome (stricture rate, erectile function, and continence).


CONCLUSIONS
The number of stitches used for VUA during radical retropubic prostatectomy did not influence the perioperative and postoperative parameters. The time to VUA was considerably lower using our "two-suture" technique.
Gallo
Luigi
L
Department of Urology, National Cancer Institute Pascale Foundation, Naples, Italy. gigginogallo@tin.it
Perdonà
Sisto
S
Autorino
Riccardo
R
Menna
Luigi
L
Claudio
Luigi
L
Marra
Luigi
L
Di Lorenzo
Giuseppe
G
Gallo
Antonio
A
D000714:Anastomosis, Surgical / Q000379:methods; D015718:Fibrin Tissue Adhesive / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000473:pathology / Q000601:surgery; D013536:Suture Techniques; D014014:Tissue Adhesives / Q000627:therapeutic use; D016896:Treatment Outcome; D014521:Urethra / Q000601:surgery*; D001743:Urinary Bladder / Q000601:surgery*
D015718:Fibrin Tissue Adhesive; D014014:Tissue Adhesives