Login to Access Video or Poster Abstract: MP93-01
Sources of Funding: none

Introduction

To report our new vesicourethral anastomosis technique during robot assisted radical prostatectomy and test its impact on the immediate and early continence rates .

Methods

Between January-June 2016, 60 patients were enrolled in the study and data collected prospectively. Modified vesicourethral anastomosis was performed by a single surgeon. The new technique was based on stabilizing the posterior urethra with anastomosis sutures before transecting the prostatic urethra. Two 3/0 barbed sutures were passed from the urethra at 5 o clock and 7 o clock positions and then used for vesicourethral anastomosis. This cohort of patients (Group I, 60 pts) was compared with the most recent consecutive patients in whom standard continuous running anastomosis technique was used prior to initiating the new technique (Group II, 60 pts). Post catheter removal 1st week and 1st month continence status were compared with the standard technique using ICIQ-SF form and 1st month overactive bladder questionnaire form. Preoperative ICIQ-SF scores were aslo obtained for both groups but there were no statistical significant distance between groups.

Results

Groups were compared in terms of Prostate specific antigen (EBL), age, body mass index (BMI), American society of anesthesiology score (ASA), prostate volume, final gleason score, operation and anastomosis time, and estimated blood loss (EBL). Also surgical margin positivity, bladder neck reconstruction rate, lymph node invasion rate were compared. Only statistically significant difference was encountered in modified anastomosis group in terms of age; group II was younger compared to group I. (61+7.5 vs. 64+7.6, p<0.05). For the 1st week of post catheter removal, mean ICIQ-SF scores for group I and -group II were 4.1+5.7 vs. 12.1+4.1 respectively (p<0.001). Recatheterization was needed in ;4 of 60 patients in Group 1 and 1 of 60 patients in Group 2 ;(p>0.05). Similarly; 1st month ICIQ-SF scores for group II and group I were 10.8+4.4 vs. 2.6 +4.3, respectively (p<0.001). Overactive bladder questionnaire scores were also compared. There was a statistically significant difference between two groups in favor of group I (18+7.7 vs. 5.3+6.2) (p<0.001).

Conclusions

Modified anastomosis technique seems to have better early continence rates compared to the standard technique. Moreover, overactive bladder symptoms were significantly less common with the novel anastomosis technique. Further randomized studies are needed to better evaluate the effect and reproducibility of this new technique.

Funding

none