Laparoscopic "single knot-single running" suture vesico-urethral anastomosis with posterior musculofascial reconstruction

World J Urol. 2012 Oct;30(5):651-7. doi: 10.1007/s00345-012-0840-2. Epub 2012 Feb 26.

Abstract

Purpose: To describe results of a simplified technique to configure the vesicourethral anastomosis and to restore posterior musculofascial plate during laparoscopic radical prostatectomy with a "single knot-single running" suture.

Methods: Between December 2006 and 2009, a conventional Van Velthoven anastomosis (group A) was applied in 125 cases while the novel anastomosis was applied in 155 consecutive patients (group B). A between group comparison of continence recovery was performed with log-rank test and Chi-square test. Continuous variables were compared with Wilcoxon's test and categorical ones with Chi-square test.

Results: Median operative time and median time to configure the anastomosis were comparable between two groups. Proportions of patients using 0 pad, 1 pad and >1 pad per day were statistically different between groups at 1 month (54.4%, 14.4%, 31.2% vs. 52.3%, 27.7%, 20%, in group A and group B, respectively; p = 0.01), at 3 months (73.6%, 8.8%, 17.6% vs. 86.5%, 7.1%, 6.5%; p = 0.01) and at 6 months (80.8%, 12.8%, 6.4% vs. 92.3%, 6.5%, 1.2%; p = 0.01). At log-rank test, continence recovery between two groups was statistically different (p = 0.008).

Conclusions: The excellent outcome together with the easiness of performing this novel anastomosis compared to the traditional Van Velthoven make it widely reproducible.

Publication types

  • Clinical Trial
  • Comparative Study

MeSH terms

  • Aged
  • Anastomosis, Surgical / methods
  • Fasciotomy*
  • Humans
  • Laparoscopy / methods*
  • Male
  • Middle Aged
  • Operative Time
  • Plastic Surgery Procedures / methods*
  • Postoperative Complications / prevention & control
  • Prospective Studies
  • Prostate / surgery
  • Prostatectomy / methods*
  • Suture Techniques*
  • Urethra / surgery*
  • Urinary Bladder / surgery
  • Urinary Incontinence / prevention & control