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The impact of bladder neck mucosal eversion during open radical prostatectomy on bladder neck stricture and urinary extravasation

  • Urology – Original Paper
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Abstract

Purpose

To determine whether the bladder neck mucosal eversion (BNM-eversion) during radical retropubic prostatectomy (RRP) reduces the risk of bladder neck stricture (BNS) and of peri-anastomotic extravasation (PAE) in postoperative cystography.

Methods

Two hundred and eleven patients with clinically localized prostate cancer underwent RRP and were prospectively randomized into patients with BNM-eversion (group I) and without BNM-eversion (group II). All patients underwent an evaluation of PAE by retrograde cystography on postoperative day 8. We assessed BNS after 6 months.

Results

Ninety-two patients with and 113 patients without BNM-eversion were included. There was no significant difference in baseline characteristics, including age, TNM-classification, Gleason score, PSA, prostate volume, and blood loss in both groups. A complete follow-up of 6 months for BNS was available for 188 patients (89.1 %). Sixteen BNS out of 188 patients were recorded, 4.7 % (n = 4) in group I and 11.7 % (n = 12) in group II (p = 0.09). Data from 205 out of 211 patients were available for the evaluation of the extravasation by cystography. Peri-anastomotic extravasation was detectable in 11.96 %, (11/205) in group I and in 21.24 % (24/205) in group II (p = 0.08).

Conclusion

BNM-eversion does not have a positive influence on the prevention of bladder neck strictures. Peri-anastomotic extravasation detected by cystography does not correlate with a formation of bladder neck stricture.

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Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Urology, University Hospitals Grosshadern, Ludwig-Maximilians-University, Munich, Germany

    Gita M. Schoeppler, Dirk Zaak, Petra Schuhmann, Oliver Reich, Michael Seitz, Wael Y. Khoder, Michael Staehler, Christian G. Stief & Alexander Buchner

  2. Department of Urology, University Hospital Heidelberg, Heidelberg University, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany

    Gita M. Schoeppler

  3. Department of Clinical Radiology, University Hospitals Grosshadern, Ludwig-Maximilians-University, Munich, Germany

    Dirk-Andre Clevert

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  1. Gita M. Schoeppler
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  2. Dirk Zaak
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  3. Dirk-Andre Clevert
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  4. Petra Schuhmann
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  5. Oliver Reich
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  8. Michael Staehler
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  10. Alexander Buchner
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Corresponding author

Correspondence to Gita M. Schoeppler.

Additional information

Gita M. Schoeppler and Alexander Buchner contributed equally to the study.

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Schoeppler, G.M., Zaak, D., Clevert, DA. et al. The impact of bladder neck mucosal eversion during open radical prostatectomy on bladder neck stricture and urinary extravasation. Int Urol Nephrol 44, 1403–1410 (2012). https://doi.org/10.1007/s11255-012-0186-0

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  • DOI: https://doi.org/10.1007/s11255-012-0186-0

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