title: Significance of the intraoperative methylene blue test for postoperative evaluation of the vesicourethral anastomosis.
abstract: We prospectively investigated whether routine evaluation of the vesicourethral anastomosis (VUA) after radical prostatectomy can be waived. Primary integrity of the VUA was analysed by an intraoperative methylene-blue test (IMBT) and postoperatively by conventional cystography. Data on the IMBT, contrast extravasation and prostate volume as well as pad usage were collected prospectively. Significantly more patients with a primary watertight anastomosis demonstrated by the MBT had no leakage in the postoperative cystography (P < 0.001). In a multivariate logistic regression with adjustment for prostate size and surgeon, the positive correlation between IMBT and postoperative cystography remained statistically significant (P = 0.001). The IMBT is easy to perform, inexpensive, and timesaving. With it postoperative evaluation of VUA for integrity can be waived in a significant number of patients. Following our algorithm, the Foley can be removed without further testing of the VUA, whenever the IMBT detected no leakage.
authors.affiliation: Department of Urology, University Hospital of Heidelberg, 69120 Heidelberg, Germany.
authors.forename: J N
authors.initials: JN
authors.lastname: Nyarangi-Dix
authors.forename: S
authors.initials: S
authors.lastname: Pahernik
authors.forename: J L
authors.initials: JL
authors.lastname: Bermejo
authors.forename: L
authors.initials: L
authors.lastname: Prado
authors.forename: M
authors.initials: M
authors.lastname: Hohenfellner