The Effect of Ureteral Stent Placement Before Radical Prostatectomy on the Safety of Ureteral Dissection and the Surgeon’s Comfort

Abstract

Objective: This study investigated the role of preoperative ureteral stent placement in reducing the risk of ureteral injury, an intraoperative complication of radical retropubic prostatectomy (RRP), and its contribution to the surgeon’s comfort. Materials and Methods: Open RRP was performed in 66 patients diagnosed with localized prostate cancer in our clinic between 2010 and 2015. The patients were divided into two groups; group 1 (n=34) underwent surgery without ureteral stent placement and group 2 (n=32) had surgery following the placement of a ureteral stent. The cases were preoperatively evaluated by suprapubic and transrectal ultrasonography. Perioperative and postoperative complications of all cases were determined. Both groups were assessed in terms of ureteral injury, operative time, and surgeon’s comfort. Results: The mean age of the patients in group 1 and group 2 was 61.12±5.92 (50-72) years and 63.58±6.2 (51-75) years, respectively. The mean prostate volume was 76.8±2.41 and 72.4±3.53 cc in groups 1 and 2, respectively. The mean operative time was 143.9±3.06 minutes in group 1 and 136.8±2.83 minutes in group 2. Partial ureteral injury occurred in three patients in group 1 and was repaired intraoperatively. Of these patients, two had previously undergone radiotherapy for prostate cancer and it was difficult to perform prostate dissection intraoperatively. The remaining patient had a history of transurethral resection of the prostate. No ureteral injury was observed in any of the patients in group 2. Conclusion: Preoperative ureteral stent placement in selected patients can facilitate ureteral dissection and reduce ureteral injury risk.

Keywords

• Prostatic neoplasms
• prostatectomy
• ureter
• stents