title: Transrectal contrast-enhanced ultrasonography, transrectal ultrasonography and retrograde cystography for the detection of vesicourethral anastomosis leakage after radical retropubic prostatectomy: a prospective comparative evaluation.
abstract: OBJECTIVE
  To evaluate the diagnostic accuracy of cystography (CG), transrectal ultrasonography (TRUS) and transrectal contrast-enhanced ultrasonography (CEUS) for the detection of vesicourethral extravasation (VE) after radical retropubic prostatectomy (RRP).
  
  
  METHODS
  In 80 consecutive patients who underwent RRP, the strength of the vesicourethral anastomosis (VUA) was assessed by CG, TRUS and transrectal CEUS. The investigation started with a conventional CG evaluated by an experienced uroradiologist. Following this, patients underwent TRUS which was performed by an experienced urologist who was blinded to the CG findings. The examination started with a conventional B-scan and, subsequently, a CEUS was performed by emptying and refilling the bladder with 90 ml of NaCl 0.9% + 10 ml suspension of 1:10 SonoVue and NaCl 0.9%.
  
  
  RESULTS
  26 patients (32.5%) presented urinary VE and 54 (67.5%) a watertight VUA. In 16 patients (61%) we observed a small leakage, 9 patients (35%) presented a moderate VE, and a large VE was detected in 1 patient (4%). No statistically significant difference in detection of VE was found among the three tests (p = 0.472).
  
  
  CONCLUSIONS
  TRUS and CEUS are able to provide information about the integrity of the VUA that is comparable with that of CG.
authors: Urology Unit, Magna Græcia University of Catanzaro, Catanzaro, Italy. cantiello@unicz.it
authors: Francesco
authors: F
authors: Cantiello
authors: Antonio
authors: A
authors: Cicione
authors: Riccardo
authors: R
authors: Autorino
authors: Cosimo
authors: C
authors: De Nunzio
authors: Andrea
authors: A
authors: Tubaro
authors: Rocco
authors: R
authors: Damiano
mesh_terms: D000368:Aged; D057868:Anastomotic Leak / Q000000981:diagnostic imaging* / Q000209:etiology; D003287:Contrast Media; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D010743:Phospholipids; D010865:Pilot Projects; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011468:Prostatectomy / Q000009:adverse effects*; D011859:Radiography; D015203:Reproducibility of Results; D013459:Sulfur Hexafluoride; D016896:Treatment Outcome; D014463:Ultrasonography; D014521:Urethra / Q000000981:diagnostic imaging / Q000601:surgery*; D001743:Urinary Bladder / Q000000981:diagnostic imaging / Q000601:surgery*; D014945:Wound Healing
chemical_list: D003287:Contrast Media; D010743:Phospholipids; C420843:contrast agent BR1; D013459:Sulfur Hexafluoride