title: [Transrectal ultrasound assessment of anastomosis after videolaparoscopic radical prostatectomy: our experience].
abstract: BACKGROUND
  Trans-Rectal UltraSound (TRUS) has proved to be an accurate procedure comparable to that of Fluoro-cystography (FC) to assess vesicourethral anastomosis after radical prostatectomy, with the advantages of lower costs, no radiation exposure and no dependence on the radiology department.
  
  
  METHODS
  60 Video Laparoscopic Radical Prostactomies (VLRP) were performed at our institution between September 2008 and January 2010. All patients underwent anatomosis assessment on postoperative day 6 with TRUS (Aloka A7 US machine with endorectal end-fire probe). 200 ml of sterile saline was manually instilled into the bladder by an assistant, while TRUS visualization of anastomosis was carried out by an urologist. The test was considered positive if any expanding anechoic shadow developed beside the anastomosis. In case of negative test the catheter was removed. In case of positive test the catheter was left in place and reassessment was performed every 5-7 days with both TRUS and FC, until negative result.
  
  
  RESULTS
  At the initial TRUS assessment we had 4 positive and 56 negative tests. Three out of the four patients with a positive test had a second assessment on p.o. day 14, which gave a negative result. The 4th positive case had a positive second assessment on p.o. day 14 and a third negative one on p.o. day 21. In a total of 20 assessments both TRUS and FC were performed. The results of the two procedures were always in accordance.
  
  
  CONCLUSIONS
  We have introduced TRUS assessment of vescicourethral anastomosis after laparoscopic radical prostatectomy as a routine procedure in our department. We are planning a comparative study, using FC as the gold standard, for validation purposes.
authors: UO di Urologia Ospedale di Desio (Monza Brianza), Italy.
authors: Francesco
authors: F
authors: Franzoso
authors: Silvia
authors: S
authors: Confalonieri
authors: Salvatore
authors: S
authors: Scuzzarella
authors: Igor
authors: I
authors: Piacentini
authors: Flavio
authors: F
authors: Fortuna
authors: Achille
authors: A
authors: Bianchi
authors: Luca
authors: L
authors: Colapaoli
mesh_terms: D000230:Adenocarcinoma / Q000601:surgery; D000283:Administration, Intravesical; D000368:Aged; D000714:Anastomosis, Surgical; D057868:Anastomotic Leak / Q000000981:diagnostic imaging*; D005119:Extravasation of Diagnostic and Therapeutic Materials; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care / Q000379:methods*; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000601:surgery; D012189:Retrospective Studies; D012965:Sodium Chloride / Q000008:administration & dosage; D014463:Ultrasonography; D014521:Urethra / Q000000981:diagnostic imaging* / Q000601:surgery; D001743:Urinary Bladder / Q000000981:diagnostic imaging* / Q000601:surgery; D020535:Video-Assisted Surgery
chemical_list: D012965:Sodium Chloride