Surgical technique stabilization of urethrovesical anastomosis in order to improve the results of early recovery of urine retention after retropubic prostatectomy

• Main Authors: I. A. Sikhvardt, B. Ya. Alekseev, O. V. Leonov, E. I. Kopyltsov, M. S. Mazhbich, V. A. Vodolazskiy
• Format: Article
• Language: Russian
• Published: ABV-press 2019-01-01
• Series: Onkourologiâ
• Subjects: prostate cancer; retropubic prostatectomy; urinary incontinence; stabilization of urethrovesical anastomosis
• Online Access: https://oncourology.abvpress.ru/oncur/article/view/882
• ISSN: 1726-9776; 1996-1812

Objective: to develop and substantiate the method of stabilization of urethrovesical anastomosis with retropubic prostatectomy to improve the results of early recovery of urinary retention.Materials and methods. 58 patients who had undergone radical prostatectomy were enrolled into the prospective study. The patient population was divided into two groups by the blinded randomization. The first control group consists of 29 men who underwent traditional routine surgical treatment. The second main group (29 patients) who underwent novel surgical treatment with making urethrocysteoanastomosis based on original method (Patent for invention № 2559588 from 14 Jul 2015 “Method of propylaxis of urinary incontinence after retropubic prostatectomy”).Results. At the moment of the hospital discharge the urine continence was achieved by the 20.7 % (n = 6) patients from the first group and 48.3 % (n = 14) patients from the second group. During the follow-up period in a month after surgery urine continence was maintained by the 37.9 % (n = 11) patients from the first group and 72.4 % (n = 23) patients from the second group, in three months after surgery — 62.0 % (n = 18) patients from the first group and 79.3 % (n = 23) patients from the second group. After the 6 months follow-up period 75.9 % (n = 22) patients from the first group and 86.2 % (n = 25) patients from the second group maintain urine continence. One-year follow-up period showed urine continence in 89.7 % (n = 26) patients from the first group and 93.1 % (n = 27) patients from the second group Conclusion. The surgical technique developed and introduced into clinical practice made it possible to stabilize urethrocysteoanastomosis, prevent or significantly shorten the incontinence period within the first year after retropubic prostatectomy, and improve the quality of life of patients.