[Postoperative monitoring of anastomosis after radical retropubic prostatectomy Transrectal ultrasound can replace cystography?].
OBJECTIVE
We determined if transrectal ultrasound (TRUS) is as reliable as cystography in detecting vesicourethral extravasates after radical retropubic prostatectomy (RRP).


METHODS
Between October 2005 and February 2006 we prospectively investigated 100 consecutive patients undergoing RRP. The vesicourethral anastomosis was proven 6 days after operation by a combined investigation with TRUS and cystography.


RESULTS
In the majority of patients (79%) the vesicourethral anastomosis was watertight on postoperative day 6 (POD) or showed minimal leakage (8%) so that the urinary catheter was removed. Different degrees of paravasates were detected in 21 patients. Because of small, moderate, or marked paravasations the indwelling catheter was removed on POD 9, 14, and 21 in 5, 3, and 5 patients, respectively. Every paravasate documented by cystography had been detected by TRUS before. Therefore, TRUS showed no false-negative result in detecting insufficient anastomosis. In two patients paraurethral fluid was detected by TRUS mimicking anastomotic paravasation, without confirmation by cystography.


CONCLUSIONS
TRUS can safely replace cystography to detect anastomotic leakage after radical prostatectomy.
Urologische Klinik, Marienhospital Herne, Ruhr-Universität Bochum, Widumer Strasse 8, 44627 Herne. thilo.eggert@marienhospital-herne.de
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Eggert
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Palisaar
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Metz
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Noldus
D000368:Aged; D000714:Anastomosis, Surgical; D002408:Catheters, Indwelling; D003287:Contrast Media / Q000008:administration & dosage; D019160:Endosonography; D005119:Extravasation of Diagnostic and Therapeutic Materials / Q000175:diagnosis; D006801:Humans; D008297:Male; D008875:Middle Aged; D011134:Polysaccharides; D011183:Postoperative Complications / Q000175:diagnosis*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011468:Prostatectomy; D011859:Radiography; D013529:Surgical Wound Dehiscence / Q000175:diagnosis*; D014521:Urethra / Q000601:surgery; D001743:Urinary Bladder / Q000000981:diagnostic imaging* / Q000601:surgery
D003287:Contrast Media; D011134:Polysaccharides; C059891:SHU 508