Introduction
Prostate cancer (PCa), the most common cancer of men, accounts for
approximately one third of all cancers in men.1Although there are treatment options such as high-intensity focused
ultrasound, cryoablation and radiotherapy, the vast majority of men
undergo open retropubic radical prostatectomy (RRP), which is the gold
standard in the treatment of this disease.2 With the
developing technique and technology, minimally invasive treatment
methods have become popularized in urological oncological surgery.
Robotic radical prostatectomy, which is one of these techniques, has
revolutionized PCa surgical treatment with the benefits it provides to
surgeons. However, the high cost of the robotic platform and the long
learning curve of the laparoscopic technique prevented them from
spreading globally, and in most centers, RRP is still the most performed
technique.
In radical prostatectomy, it is of great importance to achieve optimal
functional results in addition to oncological control. Vesicourethral
anostomosis (VUA) technique affects significant complications such as
colllum sclerosis and incontinence affecting the course of surgery
results. Various modifications have been developed to optimize
anostomosis and avoid those complications. In the past, Walsh, who has
contributed greatly to the development of the RRP technique, proposed 6
focal sutures for VUA.3 Then, this technique was tried
to be modified and the results of studies dealing with suturing sites,
numbers and continuous suturing were published.4-6These techniques have been tried to be performed in laparoscopic and
robotic techniques besides open technique. In addition to these
modifications, a technique, in which a completely sutureless anostomosis
was made, appeared in the literatüre.7 Their common
goal was to optimize the functional results after VUA.
It is an undeniable fact that VUA technique affects important functional
results, especially anostomosis stricture. There is no consensus in the
literature on the optimal anostomosis technique and more studies are
needed to clarify this issue. In this study, we aimed to evaluate the
effect of two different VUA techniques that we frequently use in our
clinic on functional outcomes.