Vesicourethral reconstruction in radical retropubic prostatectomy: an alternative technique.

Abstract

We review an alternative method of vesicourethral reconstruction in patients undergoing radical retropubic prostatectomy for adenocarcinoma of the prostate. A total of 91 consecutive patients were prospectively evaluated for an alternative technique for vesicourethral reconstruction which incorporates specific principles of direct suture anastomosis and the modified Vest technique. Perioperative and postoperative complications were reviewed. Total continence was reported in 80 of 91 patients (87.9%). Persistent moderate to severe incontinence was present in 1 patient and anastomotic stricture was identified in 7 (7.7%). Prolonged urinary extravasation was rare. This method of vesicourethral reconstruction appears to offer an efficient, reproducible alternative to direct suture anastomosis with acceptable complication rates.