title: Optimizing the formation of vesicourethral anastomosis and reduction of procedure time. A two-year experience with a modified technique for endoscopic running vesicourethral anastomosis.
abstract: BACKGROUND
  Creation of a watertight vesicourethral anastomosis is a challenging and time-consuming procedure. In an attempt to simplify this critical step of radical prostatectomy we have developed a laparoscopic running single suture technique and presented preliminary results previously. Here we report our two-year experience with the Chlosta's single running suture technique.
  
  
  METHODS
  Between January 2013 and June 2014, 60 consecutive patients underwent laparoscopic radical prostatectomy with a running vesicourethral anastomosis using our modified technique for clinically localized prostate cancer. Analyses of the patients' data from a prospectively maintained database with respect to perioperative characteristics, morbidity and urinary continence was performed.
  
  
  RESULTS
  The mean anastomotic time was 10.2 min. There was no clinically significant anastomotic leakage observed. Only 3 patients developed perioperative morbidity, but none of them was classified as major. Bladder neck contracture occurred in only one man and it was managed endoscopically. Overall continence rates at 3, 6, 12, and 18 months were 73%, 85%, 96.7%, and 95%, respectively, and 76.8%, 89.3%, 96.4%, and 96.4%, respectively when analysis was limited to those without adjuvant radiotherapy.
  
  
  CONCLUSIONS
  Obtained results confirm our initial observation from the preliminary report and support the use of our single running suture for the vesicourethral anastomosis in LRP.
authors.affiliation: Department of Urology, Collegium Medicum at the Jagiellonian University, Cracow, Poland.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Golabek
authors.affiliation: Department of Urology, Collegium Medicum at the Jagiellonian University, Cracow, Poland.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Wiatr
authors.affiliation: Department of Urology, Collegium Medicum at the Jagiellonian University, Cracow, Poland.
authors.forename: Mikolaj
authors.initials: M
authors.lastname: Przydacz
authors.affiliation: Department of Endocrinology and Diabetes Mellitus, Diabetes Resource Centre, North Tyneside General Hospital, North Shields, United Kingdom.
authors.forename: Jakub
authors.initials: J
authors.lastname: Bukowczan
authors.affiliation: Department of Urology, Collegium Medicum at the Jagiellonian University, Cracow, Poland.
authors.forename: Przemyslaw
authors.initials: P
authors.lastname: Dudek
authors.affiliation: Department of Cardiovascular Surgery and Transplantology The John Paul II Hospital, Cracow, Poland.
authors.forename: Robert
authors.initials: R
authors.lastname: Sobczynski
authors.affiliation: Sucha Beskidzka Regional Clinic, Sucha Beskidzka, Poland.
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Golabek
authors.affiliation: Department of Urology, Collegium Medicum at the Jagiellonian University, Cracow, Poland.
authors.forename: Piotr L
authors.initials: PL
authors.lastname: Chłosta
keywords: laparoscopic radical prostatectomy; surgical technique; vesicourethral anastomosis