Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/10728
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dc.contributor.authorWebb, David Ren
dc.contributor.authorSethi, Kapilen
dc.contributor.authorGee, Kieraen
dc.date.accessioned2015-05-16T00:16:17Z
dc.date.available2015-05-16T00:16:17Z
dc.date.issued2008-12-05en
dc.identifier.citationBJU International 2008; 103(7): 957-63en
dc.identifier.govdoc19076148en
dc.identifier.otherPUBMEDen
dc.identifier.urihttps://ahro.austin.org.au/austinjspui/handle/1/10728en
dc.description.abstractTo evaluate the difference in outcome of bladder neck contracture (BNC) and its causes between large groups of patients undergoing open radical prostatectomy (ORP) and robot-assisted laparoscopic prostatectomy (RALP).We analysed 200 consecutive RPs performed by one surgeon for prostate cancer, 100 by ORP and 100 by RALP, between March 2003 and September 2007. The operative techniques of bladder neck repair and urethro-vesical anastomosis were different. The ORP patients had a conventional stomatization and 'racquet handle' repair of the bladder if necessary, with mucosal eversion and a direct circular interrupted 'end-to-end' suture anastomosis between the bladder and urethra. The RALP patients had no bladder neck reconstruction or mucosal eversion and their anastomosis was by the continuous suture 'parachute' technique.There was no BNC in the RALP group, whilst 9% of the ORP group developed a BNC (P < 0.005). Apart from surgical technique, other variables, including patient age, previous transurethral resection of the prostate, Gleason score, T stage, urine infection rate, urinary leakage, blood loss, drain tube removal, anastomotic suture material, catheter type and catheter removal times were statistically comparable in both groups.This series suggests that the major factor involved in the cause of bladder neck contracture after ORP, relates to the stomatization or 'racquet handle' bladder neck repair, and the end-to-end anastomosis between the urethra and stomatized bladder. Mucosal eversion might also contribute. Normal postoperative urinary leakage when the anastomotic apposition is good seems unlikely to be a significant aetiological factor in the development of BNC. Prolonged urinary leakage results from an anastomotic gap, which heals by second intention, thereby causing scarring and BNC. The RALP 'parachute' technique, which expands the anastomosis towards the bladder, appears to protect against BNC. Mucosal eversion is not necessary in the parachute repair.en
dc.language.isoenen
dc.subject.otherAgeden
dc.subject.otherAnastomosis, Surgicalen
dc.subject.otherContracture.etiologyen
dc.subject.otherHumansen
dc.subject.otherLaparoscopy.adverse effectsen
dc.subject.otherMaleen
dc.subject.otherMiddle Ageden
dc.subject.otherProstatectomy.adverse effects.methodsen
dc.subject.otherProstatic Neoplasms.surgeryen
dc.subject.otherRoboticsen
dc.subject.otherSuturesen
dc.subject.otherUrinary Bladder Neck Obstruction.etiologyen
dc.titleAn analysis of the causes of bladder neck contracture after open and robot-assisted laparoscopic radical prostatectomy.en
dc.typeJournal Articleen
dc.identifier.journaltitleBJU Internationalen
dc.identifier.affiliationUniversity of Melbourne, Surgery and Urology, Austin Hospital, Australiaen
dc.identifier.doi10.1111/j.1464-410X.2008.08278.xen
dc.description.pages957-63en
dc.relation.urlhttps://pubmed.ncbi.nlm.nih.gov/19076148en
dc.type.austinJournal Articleen
item.openairecristypehttp://purl.org/coar/resource_type/c_18cf-
item.cerifentitytypePublications-
item.fulltextNo Fulltext-
item.grantfulltextnone-
item.languageiso639-1en-
item.openairetypeJournal Article-
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