The impact of bladder neck mucosal eversion during open radical prostatectomy on bladder neck stricture and urinary extravasation

Purpose: To determine whether the bladder neck mucosal eversion (BNM-eversion) during radical retropubic prostatectomy (RRP) reduces the risk of bladder neck stricture (BNS) and of peri-anastomotic extravasation (PAE) in postoperative cystography.Methods: Two hundred and eleven patients with clinica...

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1. Verfasser: Schöppler, Gita (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: 15 May 2012
In: International urology and nephrology
Year: 2012, Jahrgang: 44, Heft: 5, Pages: 1403-1410
ISSN:1573-2584
DOI:10.1007/s11255-012-0186-0
Online-Zugang:Verlag, Volltext: http://dx.doi.org/10.1007/s11255-012-0186-0
Verlag, Volltext: https://link.springer.com/article/10.1007/s11255-012-0186-0
Volltext
Verfasserangaben:Gita M. Schoeppler, Dirk Zaak, Dirk-Andre Clevert, Petra Schuhmann, Oliver Reich, Michael Seitz, Wael Y. Khoder, Michael Staehler, Christian G. Stief, Alexander Buchner

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245 1 4 |a The impact of bladder neck mucosal eversion during open radical prostatectomy on bladder neck stricture and urinary extravasation  |c Gita M. Schoeppler, Dirk Zaak, Dirk-Andre Clevert, Petra Schuhmann, Oliver Reich, Michael Seitz, Wael Y. Khoder, Michael Staehler, Christian G. Stief, Alexander Buchner 
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520 |a Purpose: To determine whether the bladder neck mucosal eversion (BNM-eversion) during radical retropubic prostatectomy (RRP) reduces the risk of bladder neck stricture (BNS) and of peri-anastomotic extravasation (PAE) in postoperative cystography.Methods: Two hundred and eleven patients with clinically localized prostate cancer underwent RRP and were prospectively randomized into patients with BNM-eversion (group I) and without BNM-eversion (group II). All patients underwent an evaluation of PAE by retrograde cystography on postoperative day 8. We assessed BNS after 6 months.Results: Ninety-two patients with and 113 patients without BNM-eversion were included. There was no significant difference in baseline characteristics, including age, TNM-classification, Gleason score, PSA, prostate volume, and blood loss in both groups. A complete follow-up of 6 months for BNS was available for 188 patients (89.1 %). Sixteen BNS out of 188 patients were recorded, 4.7 % (n = 4) in group I and 11.7 % (n = 12) in group II (p = 0.09). Data from 205 out of 211 patients were available for the evaluation of the extravasation by cystography. Peri-anastomotic extravasation was detectable in 11.96 %, (11/205) in group I and in 21.24 % (24/205) in group II (p = 0.08).Conclusion: BNM-eversion does not have a positive influence on the prevention of bladder neck strictures. Peri-anastomotic extravasation detected by cystography does not correlate with a formation of bladder neck stricture. 
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