Outcome of precise vesicourethral anastomosis following retropubic radical prostatectomy using a Foley catheter

Abstract

Purpose: In order to evaluate precise anastomosis using a Foley catheter, complications following radical retropubic prostatectomy were examined. Methods: Twenty-one patients underwent radical retropubic prostatectomy. Precise vesicourethral anastomosis was performed, visualizing the urethral stump by raising up the urogenital diaphragm using a Foley catheter. Complications, such as prolonged urinary extravasation and temporary urinary retention, were checked when the catheter was removed. Incontinence was evaluated both within 6 weeks and more than 6 weeks after operation. Anastomotic and urethral strictures were also checked during follow up. Results:The follow-up period ranged from 4 to 47 months (mean (± SD) 22.0 ± 12.1 months). Eighteen of 21 patients (85.7%) achieved continence after the operation. However, two patients still had stress incontinence and one patient had mild incontinence. Neither prolonged urinary extravasation nor temporally urinary retention were observed. Anastomotic and urethral stricture were not experienced during follow up. Conclusions: Precise anastomosis using a Foley catheter is technically easy and useful, even for relatively inexperienced urologists, to perform. Patients can often achieve continence following this procedure.

Evaluation of urinary extravasation and results after continence‐preserving radical retropubic prostatectomy

“…The surgical precision of the anastomosis was also confirmed by having no cases of urinary retention on removing the Foley catheter. Several methods for easier and more accurate anastomosis have been reported [21]; in the present study, passing a temporary suture guide to the urethra for traction on its posterior wall proved helpful, as it facilitates suture placement at the 5 and 7 o’clock positions. The size of the Foley catheter might also be important, so we prefer to use a 20 F urinary catheter.…”