To compare the outcomes of bidirectional barbed suture and continuous poliglecaprone suture for urethrovesical anastomosis (UVA) during laparoscopic radical prostatectomy (LRP).
Single-needle poliglecaprone suture was used for UVA in Group 1 (n=27), and double-needle bidirectional barbed suture was used for UVA (n=27) in Group 2. Age, body mass index (BMI), prostate-specific antigen (PSA) level, prostate volume, operative time, anastomosis time, estimated blood loss, Gleason score, number of hospitalization days, and urinary continence at postoperative month 1, 3, 6, and 12 were analyzed statistically.
There were no significant differences in age, BMI, prostate volume, PSA level, Gleason score, and indwelling catheter time between the two groups. However, bidirectional barbed suture was associated with a significantly shorter anastomosis time (P=0.007), operation time (P=0.008) and hospitalization duration (P<0.001), and a significantly lower blood loss volume (P=0.005). At the first-month follow-up, urinary continence was achieved in 5 (19%) and 15 (56%) patients in Group 1 and 2, respectively (P=0.005); postoperative third month: 11 (41%) and 23 (85%) patients in Group 1 and 2 respectively (P=0.001); postoperative sixth month: 21 (78%) and 25 (93%) patients in Group 1 and 2 respectively (P=0.250); postoperative first year: 25 (93%) and 27 (100%) patients in Group 1 and 2 respectively (P=0.471). Multivariate regression analysis showed that anastomosis time (HR =0.636; P<0.001) was an independent predictor of postoperative continence.
The current findings show that bidirectional barbed suture for UVA during LRP can shorten UVA time and provide better outcomes in terms of early urinary continence recovery.
Gland surgery. 2020 Oct [Epub]
Jiaxing Li, Qi Zhang, Jianwei Xie, Bo Yin
Department of Urology, Shengjing Hospital of China Medical University, Shenyang, China., Department of Ultrasound, Shengjing Hospital of China Medical University, Shenyang, China.