Post-operative drain output as a predictor of bladder neck contracture following radical prostatectomy
Background Bladder neck contracture (BNC) following prostatectomy has been reported in 0.5–32% of cases. While the etiology of a BNC is unclear, several factors have been associated with this complication, including blood loss, devascularization of bladder neck tissue, poor mucosal apposition and ur...
Gespeichert in:
Veröffentlicht in: | International urology and nephrology 2008-01, Vol.40 (2), p.351-354 |
---|---|
Hauptverfasser: | , , , , |
Format: | Artikel |
Sprache: | eng |
Schlagworte: | |
Online-Zugang: | Volltext |
Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
container_end_page | 354 |
---|---|
container_issue | 2 |
container_start_page | 351 |
container_title | International urology and nephrology |
container_volume | 40 |
creator | Hanson, Gregory R. Odom, Erin Borden, Lester S. Neil, Nancy Corman, John M. |
description | Background
Bladder neck contracture (BNC) following prostatectomy has been reported in 0.5–32% of cases. While the etiology of a BNC is unclear, several factors have been associated with this complication, including blood loss, devascularization of bladder neck tissue, poor mucosal apposition and urinary extravasation. To study the impact of urinary extravasation on BNC formation, we used post-operative drain output as a surrogate measure for anastomotic leakage.
Methods
All patients undergoing a radical retropubic prostatectomy (RRP) or a robotic assisted radical prostatectomy (RARP) from January 2000 to April 2006 have been entered into a prospective review board-approved database. All RRP patients had their anastomosis performed in an interrupted fashion using six monofilament 2-0 sutures. All robotic-assisted radical prostatectomy anastomoses were performed in a running fashion using 2-0 monofilament sutures. A single, closed suction Jackson Pratt drain was placed over the surgical bed at the conclusion of the case. Post-operative drain outputs were recorded. All patients were evaluated at 3, 6, 9, 12 and 24 months post-operatively. All patients who reported a diminished urinary stream or incontinence were evaluated by office cystoscopy. The inability to navigate an 18 French cystoscope through the bladder neck was defined as a bladder neck contracture.
Results
A total of 576 patients underwent a radical prostatectomy over this time span. Complete records were available for 535 (93%) of these patients. There were 21 bladder neck contractures (3.9%) overall. The post-operative drain output ranged from 5–5,465 ml (median 119 ml). Eight patients who had drain outputs less than 119 ml developed a BNC while 13 BNC developed in patients with Jackson Pratt drain output >119 ml (
P
= 0.343). In patients who underwent an open RRP, 19/424 (4.5%) developed contractures while 2/108 (1.9%) RARP patients developed a BNC (
P
= 0.105).
Conclusion
The amount of post-operative drain output is not statistically associated with the development of a bladder neck contracture. |
doi_str_mv | 10.1007/s11255-007-9239-1 |
format | Article |
fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_69429148</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>69429148</sourcerecordid><originalsourceid>FETCH-LOGICAL-c369t-87ffd08037d80dbf9cfd0e07526e6ddfd37f22c8fc640577d72de2390b1df5da3</originalsourceid><addsrcrecordid>eNp1kUFrGzEQhUVJadwkP6CXInLoTemM5JV2jyUkbSDQHtqzkKVR2HS9ciVtS_59ZWwIBHLSCH3vzYweYx8QrhDAfC6IsutEK8Ug1SDwDVthZ5SQXb8-YStQgAK1VKfsfSmPADD0AO_YKRqNA2pYsfgjlSrSjrKr41_iIbtx5mmpu6VyV7jju0xh9DVlniLfTC4Eynwm_5v7NNfsfF0y8ZimKf0b5weeXcPd1HTN2VVq0u3TOXsb3VTo4niesV-3Nz-vv4n771_vrr_cC6_0UEVvYgzQgzKhh7CJg29XAtNJTTqEGJSJUvo-er2GzphgZKC2OWwwxC44dcY-HXxb9z8LlWq3Y_E0TW6mtBSrh7UccN038PIF-JiWPLfZrESNvVHdHsID5NsuJVO0uzxuXX6yCHafgD0kYPflPgGLTfPxaLxsthSeFccvb4A8AKU9zQ-Unzu_7vofkteS8A</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>216187358</pqid></control><display><type>article</type><title>Post-operative drain output as a predictor of bladder neck contracture following radical prostatectomy</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Hanson, Gregory R. ; Odom, Erin ; Borden, Lester S. ; Neil, Nancy ; Corman, John M.</creator><creatorcontrib>Hanson, Gregory R. ; Odom, Erin ; Borden, Lester S. ; Neil, Nancy ; Corman, John M.</creatorcontrib><description>Background
Bladder neck contracture (BNC) following prostatectomy has been reported in 0.5–32% of cases. While the etiology of a BNC is unclear, several factors have been associated with this complication, including blood loss, devascularization of bladder neck tissue, poor mucosal apposition and urinary extravasation. To study the impact of urinary extravasation on BNC formation, we used post-operative drain output as a surrogate measure for anastomotic leakage.
Methods
All patients undergoing a radical retropubic prostatectomy (RRP) or a robotic assisted radical prostatectomy (RARP) from January 2000 to April 2006 have been entered into a prospective review board-approved database. All RRP patients had their anastomosis performed in an interrupted fashion using six monofilament 2-0 sutures. All robotic-assisted radical prostatectomy anastomoses were performed in a running fashion using 2-0 monofilament sutures. A single, closed suction Jackson Pratt drain was placed over the surgical bed at the conclusion of the case. Post-operative drain outputs were recorded. All patients were evaluated at 3, 6, 9, 12 and 24 months post-operatively. All patients who reported a diminished urinary stream or incontinence were evaluated by office cystoscopy. The inability to navigate an 18 French cystoscope through the bladder neck was defined as a bladder neck contracture.
Results
A total of 576 patients underwent a radical prostatectomy over this time span. Complete records were available for 535 (93%) of these patients. There were 21 bladder neck contractures (3.9%) overall. The post-operative drain output ranged from 5–5,465 ml (median 119 ml). Eight patients who had drain outputs less than 119 ml developed a BNC while 13 BNC developed in patients with Jackson Pratt drain output >119 ml (
P
= 0.343). In patients who underwent an open RRP, 19/424 (4.5%) developed contractures while 2/108 (1.9%) RARP patients developed a BNC (
P
= 0.105).
Conclusion
The amount of post-operative drain output is not statistically associated with the development of a bladder neck contracture.</description><identifier>ISSN: 0301-1623</identifier><identifier>EISSN: 1573-2584</identifier><identifier>DOI: 10.1007/s11255-007-9239-1</identifier><identifier>PMID: 17619160</identifier><identifier>CODEN: IURNAE</identifier><language>eng</language><publisher>Dordrecht: Springer Netherlands</publisher><subject>Aged ; Anastomosis, Surgical ; Contracture - etiology ; Cystoscopes ; Drainage ; Humans ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Nephrology ; Original Article ; Prostatectomy - adverse effects ; Robotics ; Suture Techniques ; Urinary Bladder Neck Obstruction - diagnosis ; Urinary Bladder Neck Obstruction - etiology ; Urination Disorders - etiology ; Urology</subject><ispartof>International urology and nephrology, 2008-01, Vol.40 (2), p.351-354</ispartof><rights>Springer Science+Business Media B.V. 2007</rights><rights>Springer Science+Business Media, B.V. 2008</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c369t-87ffd08037d80dbf9cfd0e07526e6ddfd37f22c8fc640577d72de2390b1df5da3</citedby><cites>FETCH-LOGICAL-c369t-87ffd08037d80dbf9cfd0e07526e6ddfd37f22c8fc640577d72de2390b1df5da3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s11255-007-9239-1$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s11255-007-9239-1$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,778,782,27907,27908,41471,42540,51302</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17619160$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hanson, Gregory R.</creatorcontrib><creatorcontrib>Odom, Erin</creatorcontrib><creatorcontrib>Borden, Lester S.</creatorcontrib><creatorcontrib>Neil, Nancy</creatorcontrib><creatorcontrib>Corman, John M.</creatorcontrib><title>Post-operative drain output as a predictor of bladder neck contracture following radical prostatectomy</title><title>International urology and nephrology</title><addtitle>Int Urol Nephrol</addtitle><addtitle>Int Urol Nephrol</addtitle><description>Background
Bladder neck contracture (BNC) following prostatectomy has been reported in 0.5–32% of cases. While the etiology of a BNC is unclear, several factors have been associated with this complication, including blood loss, devascularization of bladder neck tissue, poor mucosal apposition and urinary extravasation. To study the impact of urinary extravasation on BNC formation, we used post-operative drain output as a surrogate measure for anastomotic leakage.
Methods
All patients undergoing a radical retropubic prostatectomy (RRP) or a robotic assisted radical prostatectomy (RARP) from January 2000 to April 2006 have been entered into a prospective review board-approved database. All RRP patients had their anastomosis performed in an interrupted fashion using six monofilament 2-0 sutures. All robotic-assisted radical prostatectomy anastomoses were performed in a running fashion using 2-0 monofilament sutures. A single, closed suction Jackson Pratt drain was placed over the surgical bed at the conclusion of the case. Post-operative drain outputs were recorded. All patients were evaluated at 3, 6, 9, 12 and 24 months post-operatively. All patients who reported a diminished urinary stream or incontinence were evaluated by office cystoscopy. The inability to navigate an 18 French cystoscope through the bladder neck was defined as a bladder neck contracture.
Results
A total of 576 patients underwent a radical prostatectomy over this time span. Complete records were available for 535 (93%) of these patients. There were 21 bladder neck contractures (3.9%) overall. The post-operative drain output ranged from 5–5,465 ml (median 119 ml). Eight patients who had drain outputs less than 119 ml developed a BNC while 13 BNC developed in patients with Jackson Pratt drain output >119 ml (
P
= 0.343). In patients who underwent an open RRP, 19/424 (4.5%) developed contractures while 2/108 (1.9%) RARP patients developed a BNC (
P
= 0.105).
Conclusion
The amount of post-operative drain output is not statistically associated with the development of a bladder neck contracture.</description><subject>Aged</subject><subject>Anastomosis, Surgical</subject><subject>Contracture - etiology</subject><subject>Cystoscopes</subject><subject>Drainage</subject><subject>Humans</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Nephrology</subject><subject>Original Article</subject><subject>Prostatectomy - adverse effects</subject><subject>Robotics</subject><subject>Suture Techniques</subject><subject>Urinary Bladder Neck Obstruction - diagnosis</subject><subject>Urinary Bladder Neck Obstruction - etiology</subject><subject>Urination Disorders - etiology</subject><subject>Urology</subject><issn>0301-1623</issn><issn>1573-2584</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2008</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1kUFrGzEQhUVJadwkP6CXInLoTemM5JV2jyUkbSDQHtqzkKVR2HS9ciVtS_59ZWwIBHLSCH3vzYweYx8QrhDAfC6IsutEK8Ug1SDwDVthZ5SQXb8-YStQgAK1VKfsfSmPADD0AO_YKRqNA2pYsfgjlSrSjrKr41_iIbtx5mmpu6VyV7jju0xh9DVlniLfTC4Eynwm_5v7NNfsfF0y8ZimKf0b5weeXcPd1HTN2VVq0u3TOXsb3VTo4niesV-3Nz-vv4n771_vrr_cC6_0UEVvYgzQgzKhh7CJg29XAtNJTTqEGJSJUvo-er2GzphgZKC2OWwwxC44dcY-HXxb9z8LlWq3Y_E0TW6mtBSrh7UccN038PIF-JiWPLfZrESNvVHdHsID5NsuJVO0uzxuXX6yCHafgD0kYPflPgGLTfPxaLxsthSeFccvb4A8AKU9zQ-Unzu_7vofkteS8A</recordid><startdate>20080101</startdate><enddate>20080101</enddate><creator>Hanson, Gregory R.</creator><creator>Odom, Erin</creator><creator>Borden, Lester S.</creator><creator>Neil, Nancy</creator><creator>Corman, John M.</creator><general>Springer Netherlands</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QP</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope></search><sort><creationdate>20080101</creationdate><title>Post-operative drain output as a predictor of bladder neck contracture following radical prostatectomy</title><author>Hanson, Gregory R. ; Odom, Erin ; Borden, Lester S. ; Neil, Nancy ; Corman, John M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c369t-87ffd08037d80dbf9cfd0e07526e6ddfd37f22c8fc640577d72de2390b1df5da3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2008</creationdate><topic>Aged</topic><topic>Anastomosis, Surgical</topic><topic>Contracture - etiology</topic><topic>Cystoscopes</topic><topic>Drainage</topic><topic>Humans</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Nephrology</topic><topic>Original Article</topic><topic>Prostatectomy - adverse effects</topic><topic>Robotics</topic><topic>Suture Techniques</topic><topic>Urinary Bladder Neck Obstruction - diagnosis</topic><topic>Urinary Bladder Neck Obstruction - etiology</topic><topic>Urination Disorders - etiology</topic><topic>Urology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hanson, Gregory R.</creatorcontrib><creatorcontrib>Odom, Erin</creatorcontrib><creatorcontrib>Borden, Lester S.</creatorcontrib><creatorcontrib>Neil, Nancy</creatorcontrib><creatorcontrib>Corman, John M.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>International urology and nephrology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hanson, Gregory R.</au><au>Odom, Erin</au><au>Borden, Lester S.</au><au>Neil, Nancy</au><au>Corman, John M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Post-operative drain output as a predictor of bladder neck contracture following radical prostatectomy</atitle><jtitle>International urology and nephrology</jtitle><stitle>Int Urol Nephrol</stitle><addtitle>Int Urol Nephrol</addtitle><date>2008-01-01</date><risdate>2008</risdate><volume>40</volume><issue>2</issue><spage>351</spage><epage>354</epage><pages>351-354</pages><issn>0301-1623</issn><eissn>1573-2584</eissn><coden>IURNAE</coden><abstract>Background
Bladder neck contracture (BNC) following prostatectomy has been reported in 0.5–32% of cases. While the etiology of a BNC is unclear, several factors have been associated with this complication, including blood loss, devascularization of bladder neck tissue, poor mucosal apposition and urinary extravasation. To study the impact of urinary extravasation on BNC formation, we used post-operative drain output as a surrogate measure for anastomotic leakage.
Methods
All patients undergoing a radical retropubic prostatectomy (RRP) or a robotic assisted radical prostatectomy (RARP) from January 2000 to April 2006 have been entered into a prospective review board-approved database. All RRP patients had their anastomosis performed in an interrupted fashion using six monofilament 2-0 sutures. All robotic-assisted radical prostatectomy anastomoses were performed in a running fashion using 2-0 monofilament sutures. A single, closed suction Jackson Pratt drain was placed over the surgical bed at the conclusion of the case. Post-operative drain outputs were recorded. All patients were evaluated at 3, 6, 9, 12 and 24 months post-operatively. All patients who reported a diminished urinary stream or incontinence were evaluated by office cystoscopy. The inability to navigate an 18 French cystoscope through the bladder neck was defined as a bladder neck contracture.
Results
A total of 576 patients underwent a radical prostatectomy over this time span. Complete records were available for 535 (93%) of these patients. There were 21 bladder neck contractures (3.9%) overall. The post-operative drain output ranged from 5–5,465 ml (median 119 ml). Eight patients who had drain outputs less than 119 ml developed a BNC while 13 BNC developed in patients with Jackson Pratt drain output >119 ml (
P
= 0.343). In patients who underwent an open RRP, 19/424 (4.5%) developed contractures while 2/108 (1.9%) RARP patients developed a BNC (
P
= 0.105).
Conclusion
The amount of post-operative drain output is not statistically associated with the development of a bladder neck contracture.</abstract><cop>Dordrecht</cop><pub>Springer Netherlands</pub><pmid>17619160</pmid><doi>10.1007/s11255-007-9239-1</doi><tpages>4</tpages></addata></record> |
fulltext | fulltext |
identifier | ISSN: 0301-1623 |
ispartof | International urology and nephrology, 2008-01, Vol.40 (2), p.351-354 |
issn | 0301-1623 1573-2584 |
language | eng |
recordid | cdi_proquest_miscellaneous_69429148 |
source | MEDLINE; SpringerLink Journals - AutoHoldings |
subjects | Aged Anastomosis, Surgical Contracture - etiology Cystoscopes Drainage Humans Male Medicine Medicine & Public Health Middle Aged Nephrology Original Article Prostatectomy - adverse effects Robotics Suture Techniques Urinary Bladder Neck Obstruction - diagnosis Urinary Bladder Neck Obstruction - etiology Urination Disorders - etiology Urology |
title | Post-operative drain output as a predictor of bladder neck contracture following radical prostatectomy |
url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-17T00%3A21%3A05IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Post-operative%20drain%20output%20as%20a%20predictor%20of%20bladder%20neck%20contracture%20following%20radical%20prostatectomy&rft.jtitle=International%20urology%20and%20nephrology&rft.au=Hanson,%20Gregory%20R.&rft.date=2008-01-01&rft.volume=40&rft.issue=2&rft.spage=351&rft.epage=354&rft.pages=351-354&rft.issn=0301-1623&rft.eissn=1573-2584&rft.coden=IURNAE&rft_id=info:doi/10.1007/s11255-007-9239-1&rft_dat=%3Cproquest_cross%3E69429148%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=216187358&rft_id=info:pmid/17619160&rfr_iscdi=true |