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Factors predisposing to the development of anastomotic strictures in a single‐surgeon series of radical retropubic prostatectomies
Author(s) -
HUANG GEORGE,
LEPOR HERBERT
Publication year - 2006
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/j.1464-410x.2005.05908.x
Subject(s) - cystography , medicine , extravasation , radical retropubic prostatectomy , anastomosis , surgery , catheter , prostatectomy , urology , neck of urinary bladder , urinary system , incidence (geometry) , urinary bladder , prostate , cancer , physics , optics , immunology
OBJECTIVE To determine the rate of anastomotic stricture (AS) after radical retropubic prostatectomy (RRP) performed by one experienced surgeon, and to identify factors predisposing to its formation. PATIENTS AND METHODS In all, 708 men were prospectively monitored for the development of AS after RRP. Potential risk factors for AS were analysed. RESULTS There were no significant differences in age, Gleason score, nerve‐sparing status, intraoperative blood loss, degree of extravasation on initial cystography, or duration of the indwelling urinary catheter between men who developed AS and men who did not. The mean postoperative blood loss was significantly higher in men who developed AS. The incidence of AS was also significantly higher in men whose bladder necks were reconstructed more narrowly. CONCLUSION The amount of bleeding and the calibre of the reconstructed bladder neck were significantly associated with AS formation after RRP. The development of a haematoma from bleeding might explain the increased likelihood of AS. The mechanism of AS formation is unrelated to the degree of urinary extravasation on cystography, providing that a urinary catheter is left indwelling until extravasation resolves.