RETROPUBIC RADICAL PROSTATECTOMY WITH CLASSIC SUTURE TECHNIQUE AND SUTURELESS VESICOURETHRAL ANASTOMOSIS. POSTOPERATIVE OUTCOMES

Abstract

Objective: to compare the postoperative results of patients with prostate cancer treated with retropubic radical prostatectomy with classic suture technique and sutureless vesico-urethral anastomosis in Cartagena de Indias. Methods: retrospective cohort study that compared the classical technique with suture reconstruction of the vesico-urethral anastomosis during radical prostatectomy and approximation technique realigning the bladder to the urethra using only a Foley catheter. We evaluated preoperative and operative variables that included PSA, the risk of recurrence, surgical time, amount of bleeding, transfusions, catheterization time and hospital stay, and follow-up urinary incontinence and urethral stricture. Results: 36 patients participated in the study, 19 (52%) underwent sutureless technique. Prior to surgery, the groups were similar, the average PSA was 9ng/mL, half of the patients (18) had intermediate-risk of disease progression, 5 (13.9%) were high risk, 27 (75%) had localized disease, the mean operative time was 160 minutes, the median amount of bleeding (600cc), 3 (8.3%) required transfusions, hospitalization 3 days and catheter time 14, non statistically significant differences were found between the two groups. In the follow-up 17 (47%) patients had urethral stricture, 4 (26.3%) of the sutureless and 10 (58.8%) with suture group > 0.05. The overall rate of urinary incontinence and stress incontinence at 3 months was 61% and 80% respectively. In the same period of time complete urinary continence rate was 37% in the sutureless and 6% in suture group. Partial continence was 64% versus 12% respectively (p <0.05). At 12 months (66.6%) patients were completely continent, in the sutureless 16 (85%) and suture group 8 (48%) (p <0.05). Conclusion: sutureless vesicourethral anastomosis during radical retropubic prostatectomy is a simple technique with higher rates of early and complete continence after one year of follow-up compared with the suture technique. Further studies are required to corroborate the results. Rev.cienc.biomed. 2015;6(2):235-240. KEYWORDS Cancer; Prostatectomy; Prostate cancer.