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01-12-2017 | Original Article

Vesico-urethral anastomosis (VUA) evaluation of short- and long-term outcome after robot-assisted laparoscopic radical prostatectomy (RARP): selective cystogram to improve outcome

Authors: C. Tillier, H. A. M. van Muilekom, J. Bloos-van der Hulst, N. Grivas, H. G. van der Poel

Published in: Journal of Robotic Surgery | Issue 4/2017

Abstract

The role of a cystogram to assess the vesico-urethral anastomosis (VUA) after robot-assisted laparoscopic radical prostatectomy (RARP) has been debated. Early catheter removal without cystogram was reported to be associated with a trend towards an increased risk of acute urinary retention (AUR). In two cohorts we studied the effects of VUA leakage on cystogram and functional outcome after RARP. Cohort A contained 1390 consecutive men that routinely underwent a cystogram after RARP. Transurethral catheter (TUC) was removed in the absence of VUA leakage or minimal leakage on subsequent repeat cystogram. Outcome was compared to a group of 120 men that underwent cystography 7–10 days after RARP but had the TUC removed independent of cystography findings (cohort B). Outcome was assessed by early clinical follow-up and quality of life (QOL) questionnaires at 6 months. Men in cohort B had an increased risk of AUR and 6 months voiding complaints when compared to cohort A. The incidence of AUR and voiding complaints was associated with grade 2–3 leakage on cystography in cohort B but not in cohort A. Grade 2–3 leakage on cystogram was more likely in men with larger prostates larger and preoperative voiding complaints. Selective cystogram in men with larger prostates and preoperative lower urinary tract symptoms (LUTS) may prevent early AUR and voiding complaints after RARP when prolonged TUC use is applied.

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Title: Vesico-urethral anastomosis (VUA) evaluation of short- and long-term outcome after robot-assisted laparoscopic radical prostatectomy (RARP): selective cystogram to improve outcome
Authors: C. Tillier
H. A. M. van Muilekom
J. Bloos-van der Hulst
N. Grivas
H. G. van der Poel
Publication date: 01-12-2017
Publisher: Springer London
Published in: Journal of Robotic Surgery / Issue 4/2017
Print ISSN: 1863-2483
Electronic ISSN: 1863-2491
DOI: https://doi.org/10.1007/s11701-017-0677-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Vesico-urethral anastomosis (VUA) evaluation of short- and long-term outcome after robot-assisted laparoscopic radical prostatectomy (RARP): selective cystogram to improve outcome

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

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