Interrupted versus Continuous Suturing for Vesicourethral Anastomosis During Radical Prostatectomy: A Systematic...

Area of Science:

• Urology
• Surgical Oncology
• Evidence-Based Medicine

Background:

• Vesicourethral anastomosis (VUA) is a critical step in radical prostatectomy (RP).
• Both continuous suturing (CS) and interrupted suturing (IS) are commonly employed techniques for VUA.
• Current evidence does not clearly establish the superiority of one VUA technique over the other.

Purpose of the Study:

• To systematically compare continuous suturing (CS) versus interrupted suturing (IS) for VUA during radical prostatectomy (RP).
• To evaluate the impact of suture technique on key post-operative outcomes.

Main Methods:

• A systematic literature search was conducted across PubMed, Embase, and Central databases following PRISMA guidelines.
• Included studies focused on comparing CS and IS for VUA in RP.
• Outcomes assessed included catheterization time, extravasation, anastomotic time, hospital stay, continence, and stricture development.

Main Results:

• Nine studies involving 1475 patients were analyzed.
• Continuous suturing (CS) was associated with significantly shorter catheterization times (2.06 days), anastomotic times (6.39 min), and lower rates of extravasation (OR: 2.36).
• No significant differences were observed in hospital stay, urinary continence rates at 3, 6, or 12 months, or urethral stricture incidence between CS and IS.
• The overall quality of evidence was rated as low.

Conclusions:

• Continuous suturing (CS) demonstrates advantages in reducing catheterization time, anastomotic time, and extravasation rates compared to interrupted suturing (IS) for VUA during RP.
• Despite these benefits, the technical demands of CS in open RP and the low quality of existing data preclude a definitive recommendation.
• The choice between CS and IS should consider surgeon experience and the specific surgical approach.