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《Shanghai Medical Journal》 2012-09
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Risk factors and management of vesicourethral anastomotic stricture after laparoscopic radical prostatectomy

LI Tengcheng, SITU Jie, PANG Jun, LI Liaoyuan, CHEN Mingkun, QIU Jianguang, ZHOU Xiangfu, GAO Xin. Department of Urology, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou 510630, China  
Objective To analyze the potential factors contributing to vesicourethral anastomotic stricture (AS) after laparoscopic radical prostatectomy (LRP) and the efficacy of management. Methods A total of 150 patients with LRP were collected between January 2006 to June 2009. Multivariate logistic regression analysis was performed to identify whether age, preoperative prostate specific antigen (PSA), intraoperative estimated blood loss (EBL), anastomotic method, pathological stage, catheter duration and postoperative pyuria had significant associations with AS. Results Of the 150 patients, 8 (5.33%) developed AS during follow-up. Catheter duration(OR=7.98) and postoperative pyuria(OR=6.38) were positively correlated with AS (both P0.05). However, age, preoperative PSA, intraoperative EBL, anastomotic method and pathological stage were not correlated with AS in the multivariate logistic regression model (P0.05). Three patients were successfully managed by urethral dilation, whereas five patients required cold-knife incision (CKI). Conclusion Catheter duration and postoperative pyuria are significant risk factors contributing to AS formation after LRP. AS can be effectively managed with repeated urethral dilation or CKI.
【CateGory Index】: R737.25
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