A NEW METHOD OF BLADDER NECK RECONSTRUCTION DURING THE RADICAL PROSTATECTOMY IN PATIENTS WITH LOCALIZED PROSTATE CANCER
https://doi.org/10.17650/1726-9776-2011-7-3-99-106
Abstract
Radical prostatectomy is a «gold standard» for treatment of the patients with a localized prostate cancer. Urinary incontinence is one of the two most common complications of this operation. In this article we report a study aimed to compare the efficacy parameters linked to postoperative continence in 39 patients with new technique for reconstruction of the bladder neck during the radical prostatectomy using a deep suture of the bladder wall dorsally to the neck aperture with 45 patients in control group with a standard type of reconstruction in the form of tennis racket. According to the results, application of the new technique leads to a significant improvement in continence during the first 6 months after the operation with no difference among groups during follow-up later on. Given the results of the anatomical study, the efficacy of the new method of reconstruction is linked to passive closure mechanism created in the area of the bladder neck.
About the Authors
Yu. V. Tolkach
Department of Urology, S.M. Kirov Military Medical Academy, Saint Petersburg
Russian Federation
Russian Federation
S. B. S.B. Petrov
A.M. Nikiforov Department of Urology, All-Russian Center of Emergency and Radiation Medicine, Emergency Ministry of Russia
Russian Federation
Russian Federation
S. Schelin
Section of Urology, Department of Surgery, Kalmar Country Hospital, Kalmar, Sweden
Sweden
Sweden
M. V. Rezvancev
Department of Medical Service Control Automation (with Military Medical Statistics), S.M. Kirov Military Medical Academy, Saint Petersburg
Russian Federation
Russian Federation
References
1. Чиссов В.И., Старинский В.В., Петрова Г.В. Злокачественные новообразования в России в 2009 году. М., 2010.
2. Коган М.И., Лоран О.Б., Петров С.Б. Радикальная хирургия рака предстательной железы. М.: ГЭОТАР-Медиа, 2006.
3. Пушкарь Д.Ю. Радикальная простатэктомия. М.: Медпресс-информ, 2004.
4. Пушкарь Д.Ю., Раснер П.И., Бормотин А.В. Профилактика недержания мочи у больных раком простаты, перенесших радикальную простатэктомию. Онкоурология 2007; 2:45−9.
5. Демидко Ю.Л., Рапопорт Л.М., Чалый М.Е. и др. Тренировка мышц тазового дна в лечении недержания мочи после радикальной простатэктомии. Онкоурология 2010;1:49−53.
6. Павлов В.Н., Загитов А.Р., Казихинуров А.А. и др. Реабилитация больных после радикальной простатэктомии. Онкоурология 2009;1:53−5.
7. Bianco J.F.J., Riedel E.R., Begg C.B. et al. Variations among high volume surgeons in the rate of complications after radical prostatectomy: further evidence that technique matters. J Urol 2005;173(6):2099−103.
8. Cambio A.J., Evans C. Minimising postoperative incontinence following radical prostatectomy: considerations and evidence. Eur Urol 2006;50(5):903−13.
9. Hu J.C., Gold K.F., Pashos C.L. et al. Role of surgeon volume in radical prostatectomy outcomes. J Clin Oncol 2003;21:401.
10. Wein A.J. ICIQ: a brief and robust measure for evaluating the symptoms and impact of urinary incontinence. J Urol 2005; 173(3):908−9.
11. Hajebrahimi S., Corcos J., Lemieux M.C. International consultation on incontinence questionnaire short form: comparison of physician versus patient completion and immediate and delayed self administration. Urology 2004;63(6):1076−78.
12. Karantanis E., Fynes M., Moore K.H., Stanton S.L. Comparison of the ICIQ-SF and 24 hour pad test with other measures for evaluating the severity of urodynamic stress incontinence. Int Urogynecol J Pelvic Floor Dysfunct 2004;15(2):111−6.
13. Seaman E.K., Benson M.C. Improved continence with tubularized bladder neck reconstruction following radical retropubic prostatectomy. Urology 1996;47(4):532−5.
14. Steiner M.S., Burnett A.L., Brooks J.D. et al. Tubularized neourethra following radical retropubic prostatectomy. J Urol 1993; 150(2 Pt 1):407−9; discussion 409−10.
15. Walsh P.C., Marschke P.L. Intussusception of the reconstructed bladder neck leads to earlier continence after radical prostatectomy. Urology 2002;59(6):934−8.
16. Wille S., Varga Z., von Knobloch R., Hofmann R. Intussusception of bladder neck improves early continence after radical prostatectomy: results of a prospective trial. Urology 2005;65(3):524−7.
17. Sakai I., Harada K., Hara I. et al. Intussusception of the bladder neck does not promote early restoration to urinary continence after non-nerve-sparing radical retropubic prostatectomy. Int J Urol 2005;12(3):275−9.
18. Poon M., Ruckle H., Bamshad B.R. et al. Radical retropubic prostatectomy: bladder neck preservation versus reconstruction. J Urol 2000;163:194–8.
19. Paparel P., Akin O., Sandhu J.S. et al. Recovery of urinary continence after radical prostatectomy: association with urethral length and urethral fibrosis measured by preoperative and postoperative endorectal magnetic resonance imaging. Eur Urol 2009;55(3):629−37.
20. Kordan Y., Alkibay T., Sozen S. et al. Is there an impact of postoperative urethral and periurethral anatomical features in post-radical retropubic prostatectomy incontinence? Urol Int 2007;78(3):208−13.
Review
For citations:
Tolkach Yu.V., S.B. Petrov S.B., Schelin S., Rezvancev M.V. A NEW METHOD OF BLADDER NECK RECONSTRUCTION DURING THE RADICAL PROSTATECTOMY IN PATIENTS WITH LOCALIZED PROSTATE CANCER. Cancer Urology. 2011;7(3):99-106. (In Russ.) https://doi.org/10.17650/1726-9776-2011-7-3-99-106
Views:
874
Email this article 