Comparative analysis of the effectiveness of applying an additional suture to the urethrovesical anastomosis after robot-assisted prostatectomy

Abstract

Objective: to determine the effectiveness of applying an additional suture on the urethrovesical anastomosis after robot-assisted prostatectomy. Material and methods: from 2018 to 2024, a randomized, prospective study was conducted at the Urology Department of the N.I. Pirogov National Medical and Surgical Center, evaluating the outcomes of robot-assisted radical prostatectomy with bilateral neurovascular bundle preservation in 300 patients with localized prostate cancer. In Group 1, patients underwent standard robot-assisted radical prostatectomy without placement of an additional suture. In Group 2, all patients underwent robot-assisted radical prostatectomy with an additional suture placed on the urethrovesical anastomosis for supplementary prevention of anastomotic leakage. Results: at 12 months after robot-assisted radical prostatectomy, continence function was fully preserved in 86% of patients in Group 1 and in 94% of patients in Group 2. The duration of urethral catheterization was 6 ± 1 days in Group 1, compared with 4 ± 1 days in Group 2. Urethrovesical anastomotic leakage occurred in 4.5% of patients in Group 1 (n = 3) and in 1.5% of patients in Group 2 (n = 1). Conclusion: the study revealed that the rate of anastomotic leakage was 1.5% (n=1) in Group 2, compared with 4.5% (n=3) in Group 1. Fully preserved continence function was observed in 86% of patients in Group 1 and 94% of patients in Group 2.