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KMID : 0358320130540050297
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Korean Journal of Urology
2013 Volume.54 No. 5 p.297 ~ p.302
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Prevalence and Risk Factors of Bladder Neck Contracture After Radical Prostatectomy
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Cho Hee-Ju
Yoo Tag-Keun
Jung Tae-Young
Kim Duk-Yoon
Byun Seok-Soo
Kwon Dong-Deuk
Oh Tae-Hee
Ko Woo-Jin
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Abstract
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Purpose: To evaluate the prevalence of bladder neck contracture (BNC) and its risk factors in patients undergoing radical prostatectomy in Korea.
Materials and Methods: We analyzed data from 488 patients with prostatic cancer who underwent radical prostatectomy performed by seven surgeons in seven hospitals, including 365 open radical prostatectomies (ORPs), 99 laparoscopic radical prostatectomies (LRPs), and 24 robot-assisted laparoscopic radical prostatectomies (RARPs). Patients with BNCs were compared with those without BNCs to identify the risk factors for BNC occurrence.
Results: Overall, BNCs occurred in 21 of 488 patients (4.3%): 17 patients (4.7%) who underwent ORP, 4 patients (4%) who underwent LRP, and no patients who underwent RARP. In the univariate analysis, men with BNCs had a longer length of time before drain removal (12 days vs. 6.8 days, p<0.001), which reflected urinary leakage through the vesicourethral anastomosis. In the multivariate analysis, the length of time before drain removal was the only predictor of BNC (odds ratio, 1.12; p=0.001). Intraoperative blood loss was higher in patients with BNC, but the difference was not statistically significant.
Conclusions: The most significant factor related to BNC occurrence after radical prostatectomy in our study was the length of time before drain removal, which reflects urinary leakage from the vesicourethral anastomosis. The proper formation of a watertight anastomosis to decrease urinary leakage may help to reduce the occurrence of BNC.
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KEYWORD
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Prostate neoplasms, Prostatectomy, Urinary bladder neck obstruction
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