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Prevalence and Risk Factors of Bladder Neck Contracture After Radical Prostatectomy

대한비뇨기과학회지 2013년 54권 5호 p.297 ~ 302
 ( Cho Hee-Ju ) - Eulji University School of Medicine Eulji General Hospital Department of Urology

 ( Yoo Tag-Keun ) - Eulji University School of Medicine Eulji General Hospital Department of Urology
 ( Jung Tae-Young ) - Seoul Veterans Hospital Department of Urology
 ( Kim Duk-Yoon ) - Catholic University of Daegu School of Medicine Department of Urology
 ( Byun Seok-Soo ) - Seoul National University Bundang Hospital Department of Urology
 ( Kwon Dong-Deuk ) - Chonnam National University Medical School Department of Urology
 ( Oh Tae-Hee ) - Sungkyunkwan University School of Medicine Samsung Changwon Hospital Department of Urology
 ( Ko Woo-Jin ) - Yonsei University College of Medicine National Health Insurance Corporation Ilsan Hospital Department of Urology

Abstract


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.

키워드

Prostate neoplasms;Prostatectomy;Urinary bladder neck obstruction
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