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Related Experiment Videos

Is a cystogram necessary after radical prostatectomy?

Joseph J Ischia1, Stephen Lindsay

  • 1Bendigo Hospital, Bendigo Health Care Group, Bendigo, Victoria, Australia. Ischia@iinet.net.au

ANZ Journal of Surgery
|September 22, 2005
PubMed
Summary

A watertight anastomosis during radical prostatectomy surgery predicts successful healing. This finding suggests routine postoperative cystograms before a trial of void may be unnecessary, potentially streamlining patient recovery.

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Area of Science:

  • Urology
  • Surgical Oncology
  • Postoperative Care

Background:

  • Radical prostatectomy techniques have advanced, reducing postoperative catheterization times.
  • Current practice often involves cystograms to confirm anastomosis integrity before early trial of void (TOV).
  • This study investigates if intraoperative assessment can replace routine postoperative cystograms.

Purpose of the Study:

  • To determine if an intraoperative watertight vesicourethral anastomosis predicts a leak-free cystogram on postoperative day 7.
  • To assess the feasibility of omitting routine cystograms before TOV.

Main Methods:

  • Prospective study of 68 patients undergoing radical prostatectomy by a single surgeon.
  • Intraoperative assessment of vesicourethral anastomosis watertightness using saline instillation.

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  • Comparison with day 7 cystogram results to detect extravasation.

    • Main Results:

    • 79.4% of patients achieved an intraoperative watertight anastomosis.
    • 88.2% of all patients showed no extravasation on day 7 cystograms.
    • Only 2.9% of patients had unsuspected extravasation, suggesting high predictability.

    Conclusions:

    • Intraoperative watertightness of the vesicourethral anastomosis is a strong indicator of a leak-free anastomosis on day 7.
    • Routine cystograms prior to TOV may be safely omitted in patients without postoperative complications.