| Revista: | International braz j urol |
| Base de datos: | PERIÓDICA |
| Número de sistema: | 000434821 |
| ISSN: | 1677-5538 |
| Autores: | Giúdice, Carlos Roberto1 Lodi, Patricio Esteban1 Olivares, Ana Milena1 Tobia, Ignacio Pablo1 Favre, Gabriel Andrés1 |
| Instituciones: | 1Hospital Italiano de Buenos Aires, Area de Cirugía Reconstructiva, Buenos Aires. Argentina |
| Año: | 2019 |
| Periodo: | Mar-Abr |
| Volumen: | 45 |
| Número: | 2 |
| País: | Brasil |
| Idioma: | Inglés |
| Tipo de documento: | Artículo |
| Enfoque: | Analítico, descriptivo |
| Resumen en inglés | Purpose: To evaluate safety, efficacy and functional outcomes after open vesicourethral re - anastomosis using different approaches based on previous urinary continence. Materials and Methods: Retrospective study of patients treated from 2002 to 2017 due to vesicourethral anastomosis stricture (VUAS) post radical prostatectomy (RP) who failed endoscopic treatment with at least 3 months of follow-up. Continent and incontinent patients post RP were assigned to abdominal (AA) or perineal approach (PA), respectively. Demographic and perioperative variables were registered. Follow-up was completed with clinical interview, uroflowmetry and cystoscopy every 4 months. Success was defined as asymptomatic patients with urethral lumen that allows a 14 French flexible cystoscope. Results: Twenty patients underwent open re-anastomosis for VUAS after RP between 2002 and 2017. Mean age was 63.7 years (standard deviation 1.4) and median follow-up was 10 months (range 3 – 112). The approach distribution was PA 10 patients (50%) and AA 10 patients (50%). The mean surgery time and median hospital time were 246.2 ± 35.8 minutes and 4 days (range 2 – 10), respectively with no differences between approaches. No significant complication rate was found. Three patients in the AA group had gait disorder with favorable evolution and no sequels. Estimated 2 years primary success rate was 80%. After primary procedures 89.9% remained stenosis - free. All PA patients remained incontinent, and 90% AA remained continent during follow-up. Conclusion: Open vesicourethral re - anastomosis treatment is a reasonable treatment option for recurrent VUAS after RP. All patients with perineal approach remained incontinent while incontinence rate in abdominal approach was rather low |
| Disciplinas: | Medicina |
| Palabras clave: | Urología, Cirugía, Prostatectomía radical, Disfunción eréctil, Incontinencia urinaria, Cirugía reconstructiva |
| Keyword: | Urology, Surgery, Radical prostatectomy, Urinary incontinence, Erectile dysfunction, Reconstructive surgery |
| Texto completo: | Texto completo (Ver HTML) Texto completo (Ver PDF) |
