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      Bladder neck contracture-incidence and management following contemporary robot assisted radical prostatectomy technique.

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          Abstract

          Bladder neck contracture (BNC) is a well-recognized complication following robot-assisted radical prostatectomy (RARP) for treatment of localized prostate cancer with a reported incidence of up to 1.4%. In this series, we report our institutional experience and management results.

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          Technique for laparoscopic running urethrovesical anastomosis:the single knot method.

          Alexandre Peltier, Sven P. F. I. van Ommeren, Douglas W. Skarecky … (2003)
          To describe a technique for facilitating the urethrovesical anastomosis at the time of laparoscopic radical prostatectomy. Two 6-in. polyglycolic acid sutures (one dyed, one white) are tied together at their tail ends and delivered into the operative field by way of a 12-mm port. A running suture is completed from the 6:30 to the 12:00-o'clock position and from the 5:30 to the 12:00-o'clock position, at the end of which a single intracorporeal tie is completed. The catheter is placed before completing the anterior row of sutures; the catheter is left in place for 5 to 7 days. This anastomotic technique has been used in 122 laparoscopic radical prostatectomies and 8 robot-assisted laparoscopic radical prostatectomies. The average time for the anastomosis was 35 minutes (range 14 to 80). All anastomoses were watertight. No symptomatic postoperative urinary leaks have occurred, and no clinically evident clinical bladder neck contractures resulted. We describe a simple, watertight, running laparoscopic suture technique for accomplishing the urethrovesical anastomosis during laparoscopic radical prostatectomy.
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            Vattikuti Institute prostatectomy, a technique of robotic radical prostatectomy for management of localized carcinoma of the prostate: experience of over 1100 cases.

            Mani Menon, James Peabody, A. K. Hemal … (2004)
            Advances in surgical techniques, technology, and surgeons' skills have allowed robot-assisted radical prostatectomy to be an option in the management of organ-confined prostate cancer. The goals of the VIP technique are to cure cancer, preserve urinary continence, preserve potency, and decrease morbidity, along with the benefits of a minimally invasive surgery and excellent cosmesis. VIP is nearly equal to traditional retro-pubic prostatectomy, with certain outstanding advantages.
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              Incidence of urethral stricture after primary treatment for prostate cancer: data From CaPSURE.

              Sean Elliott, Maxwell Meng, Eric Elkin … (2007)
              We determined the incidence of treatment for urethral stricture, including bladder neck contracture, after primary treatment for clinically localized prostate cancer. A total of 6,597 men with newly diagnosed, localized prostate cancer and no history of urethral stricture disease were identified in the CaPSURE database. Treatment modalities included radical prostatectomy, external beam radiotherapy, brachytherapy, cryotherapy, androgen deprivation therapy, radical prostatectomy plus external beam radiotherapy, brachytherapy plus external beam radiotherapy and watchful waiting. The database was queried for patient reported history or International Classification of Diseases, 9th revision/Common Procedural Terminology codes consistent with stricture treatment after prostate cancer therapy. Time to obstruction was examined by the Kaplan-Meier method. Risk factors for stricture were examined in a multivariate Cox proportional hazards model. The incidence of stricture treatment was 344 of 6,597 cases (5.2%, range 1.1% to 8.4% by prostate cancer treatment type). Median followup was 2.7 years. In the multivariate model primary treatment type (p <0.0001), body mass index (p <0.0001) and age (p = 0.0002) were significant predictors of stricture treatment. After controlling for age and body mass index the HR for treatments compared to watchful waiting was significantly higher for radical prostatectomy (HR = 10.4, p <0.0001) and brachytherapy plus external beam radiotherapy (HR = 4.6, p = 0.0231). After radical prostatectomy most failures occurred within the first 6 months and failures were rare after 24 months, whereas after radiation failures occurred later. The risk of urethral stricture treatment after prostate cancer therapy is 1.1% to 8.4% depending on cancer treatment type. Risk was highest after radical prostatectomy or brachytherapy plus external beam radiotherapy and in those with advanced age or obesity. Stricture after radical prostatectomy occurred within the first 24 months, whereas onset was delayed after radiation.
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                Author and article information

                Journal
                Journal ID (iso-abbrev): Prostate Int
                Title: Prostate international
                Publisher: Asian Pacific Prostate Society
                ISSN: 2287-8882
                ISSN (Print): 2287-8882
                Publication date (Electronic): Mar 2014
                Volume: 2
                Issue: 1
                Affiliations
                [1 ] Section of Urologic Oncology, Rutgers Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA.
                [2 ] Section of Urologic Oncology, Rutgers Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA ; Department of Urology, Kyungpook National University Medical Center, Daegu, Korea.
                Article
                Publisher Item ID: pi-2-1-12-3
                DOI: 10.12954/PI.13034
                PMC ID: 3970984
                PubMed ID: 24693529
                SO-VID: 6023a932-2124-4f46-b6f3-df2d0369debb
                History

                Keywords: Robotics,Prostate cancer,Bladder neck contracture
                Data availability:
                Keywords: Robotics, Prostate cancer, Bladder neck contracture

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