Step-by-Step New Technique for Bladder Neck Reconstruction During Robot-Assisted Radical Prostatectomy: Adapting a Bowel Suture Technique for a Urologic Purpose

Videourology ◽  
2021 ◽  
Author(s):  
Matteo Massanova ◽  
Sophie Robertson ◽  
Felice Crocetto ◽  
Giorgio Mazzon ◽  
Guglielmo Zeccolini ◽  
...  
Keyword(s):  
Radical Prostatectomy ◽  
Bladder Neck ◽  
Suture Technique ◽  
New Technique ◽  
Robot Assisted ◽  
Neck Reconstruction ◽  
Bladder Neck Reconstruction

scholarly journals A new technique of bladder neck reconstruction during radical prostatectomy in patients with prostate cancer

2015 ◽  
Vol 41 (3) ◽  
pp. 455-465
Author(s):  
Yuri Tolkach ◽  
Konstantin Godin ◽  
Sergey Petrov ◽  
Sonny Schelin ◽  
Florian Imkamp
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Bladder Neck ◽  
New Technique ◽  
Neck Reconstruction ◽  
Bladder Neck Reconstruction ◽  
A New Technique

Robot assisted bladder neck reconstruction

2018 ◽  
Vol 17 (7) ◽  
pp. e2411
Author(s):  
W. Verla ◽  
J. Van Besien ◽  
N. Lumen
Keyword(s):  
Bladder Neck ◽  
Robot Assisted ◽  
Neck Reconstruction ◽  
Bladder Neck Reconstruction

Bowel suture technique for bladder neck reconstruction during RALP and its impact on early continence recovery

2020 ◽  
Vol 72 (5) ◽  
Author(s):  
Matteo Massanova ◽  
Maida Bada ◽  
Felice Crocetto ◽  
Biagio Barone ◽  
Davide Arcaniolo ◽  
...  
Keyword(s):  
Bladder Neck ◽  
Suture Technique ◽  
Neck Reconstruction ◽  
Bladder Neck Reconstruction

scholarly journals Management of intractable bladder neck strictures following radical prostatectomy using the Memokath®045 stent

2019 ◽  
Vol 14 (4) ◽  
pp. 621-625 ◽  
Author(s):  
A. Nathan ◽  
G. Mazzon ◽  
N. Pavan ◽  
R. De Groote ◽  
A. Sridhar ◽  
...  
Keyword(s):  
Radical Prostatectomy ◽  
Urinary Diversion ◽  
Bladder Neck ◽  
Stent Insertion ◽  
Intermittent Catheterisation ◽  
Neck Reconstruction ◽  
Clean Intermittent Catheterisation ◽  
Bladder Neck Reconstruction ◽  
The Mean

Abstract The incidence of vesicourethral anastomotic stenosis (VUAS) post radical prostatectomy varies from 1 to 26%. Current treatment can be challenging and includes a variety of different procedures. These range from endoscopic dilations to bladder neck reconstruction to urinary diversion. We investigated a 2-stage endoscopic treatment, using the thermo-expandable Memokath®045 bladder neck stent to manage patients with VUAS post radical prostatectomy. We retrospectively reviewed 30 patients, between 2013 and 2017, who underwent a Memokath®045 stent insertion following failed primary treatment (dilation and clean intermittent catheterisation) for VUAS. The mean interval time between prostatectomy and Memokath®045 stent insertion was 13 months. The mean follow-up time was 3.6 years with all patients having a minimum of 12-month follow-up. All patients had two previous attempts at endoscopic dilatation with or without incision and a trial of clean intermittent catheterisation. During stage 1, the anastomotic stricture is dilated/incised to diameter of 30 Fr, the stricture length is measured, and a catheter is left in situ. One to 2 weeks later, post haemostasis and healing, an appropriately sized Memokath®045 stent is inserted. The stent is then removed 1-year post-op. Our series of patients had a median age of 62 (54–72). Most patients (26) had a robot-assisted radical prostatectomy (RARP) or salvage procedure. Results showed improvement in IPSS scores, IPSS quality of life scores, Qmax and PVR after the Memokath®045 stent was removed compared to pre-operation. With a minimum of 12 months post stent removal, 93% of patients were fully continent, whilst 7% of patients were socially continent. 2 (7%) patients had their stents removed and not replaced due to re-stricturing and stone formation. However, no urinary tract infections, stricture recurrence or urinary retention was observed in the rest of the cohort (93%). Overall, the Memokath®045 stent was successful in treating 93% of our patients with VUAS. Our series had minimal complications that were managed with conservative measures and in three patients’ re-operation was needed. In conclusion, the Memokath®045 stent is a minimally invasive technique with faster recovery time compared to other techniques such as bladder neck reconstruction or urinary diversion. Additionally, it provides superior patency results compared to other techniques such as bladder neck incision and injection of Mitomycin C. Therefore, this management option should be considered in the management of VUAS.

scholarly journals The impact of bladder neck sparing on urinary continence during laparoscopic radical prostatectomy; Results from a high volume centre

2017 ◽  
Vol 89 (3) ◽  
pp. 186 ◽  
Author(s):  
Ali Serdar Gozen ◽  
Yigit Akin ◽  
Mutlu Ates ◽  
Marcel Fiedler ◽  
Jens Rassweiler
Keyword(s):  
Radical Prostatectomy ◽  
Bladder Neck ◽  
Multivariate Analyses ◽  
Laparoscopic Radical Prostatectomy ◽  
Urinary Continence ◽  
Neck Reconstruction ◽  
Bladder Neck Reconstruction ◽  
Group 3 ◽  
The Impact

Objective: To evaluate the effects of bladder neck reconstruction techniques on early continence after laparoscopic radical prostatectomy (LRP). Materials and methods: This non-randomized retrospective study analyzed prospectively collected data concerning LRP. In total, 3107 patients underwent LRP between March 1999 and December 2016. Exclusion criteria were preoperative urinary incontinence, previous history of external beam radiotherapy, co-morbities which may affect urinary continence such as diabetes mellitus and/or neurogenic disorders, irregular followup, and follow-up shorter than 24 months. All patients were divided into one of three groups, posterior reconstruction being performed in Group 1 (n = 112), anterior reconstruction in Group 2 (n = 762), and bladder neck sparing (BNS) in Group 3 (n = 987). Demographic and pre-, peri-, and postoperative data were collected. Multivariate analyses were performed to determine factors affecting early continence after LRP. Results: 1861 patients were enrolled in the study. The mean follow-up period was 48.12 ± 29.8 months, and subjects’ mean age was 63.6 ± 6.2 years. There was no significant difference among the groups in terms of demographic or preoperative data. Postoperative data, including oncological outcomes, were similar among the groups. The level of early continence was higher in Group 3 than in the other groups (p < 0.001). Multivariate analyses identified BNS and age as parameters significantly affecting early continence levels after LRP (p < 0.001 and p < 0.001, respectively). Bladder neck reconstruction provided less earlier continence than BNS.

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