Technical description and outcomes of a continuous anastomosis in open radical prostatectomy.
OBJECTIVE
To describe the surgical technique, objective and subjective medium-term outcomes of a novel continuous vesico-urethral anastomotic suture in open radical prostatectomy (ORP).


METHODS
A continuous anastomosis comprising separate anterior and posterior monofilament 3-0 polydioxanone sutures, with the bladder neck 'parachuted' down on to the urethral stump, was used in 39 consecutive patients. A cystogram was taken after ORP in the first 23 patients. The catheter was removed as soon as patients were fully mobile. A validated postal questionnaire to determine continence and its effect on quality of life was sent to all patients ≥3 months after ORP.


RESULTS
The mean follow-up was 18 months; there were no major complications. There was an insignificant or no leak in 91% of the patients who had a cystogram. Before discharge, 33 patients reported that they were continent, whilst five required a pad(s) for stress incontinence, and one was discharged with a catheter after failing the first catheter removal. Of the 95% who completed the questionnaire, 95% either did not leak urine, or only leaked a small amount; 84% of patients reported that leaking had a minimal effect on everyday life. No patients developed symptomatic urethral or bladder neck stricture/contracture.


CONCLUSIONS
Our technique of continuous anastomotic suturing for ORP is safe, reliable and well tolerated. Further randomized studies are warranted to compare the outcome with the standard interrupted vesico-urethral anastomosis.
Forster
James A
JA
Department of Urology, Huddersfield Royal Infirmary, Huddersfield, Yorks, UK.
Palit
Victor
V
Myatt
Andrew
A
Hadi
Saifullah
S
Bryan
Nicolas P
NP
D000368:Aged; D000714:Anastomosis, Surgical; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000209:etiology; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000601:surgery*; D016896:Treatment Outcome; D014521:Urethra / Q000601:surgery*; D001743:Urinary Bladder / Q000601:surgery*; D014549:Urinary Incontinence / Q000209:etiology