OBJECTIVE To determine whether patients with postoperative clinically detected anastomotic urine leaks are at increased risk for poorer erectile function, urinary incontinence and bladder neck contracture (BNC) after robotic-assisted laparoscopic radical prostatectomy. PATIENTS AND METHODS A retrospective review of all patients undergoing RALRP from October 2005 until December 2009 by a single surgeon (R.B.N.) was conducted. Clinically detected anastomotic urine leak was defined as drain output consistent with urine at more than 24 h postoperatively. The presence of BNC was identified on cystoscopy. Erectile function was measured with the Sexual Healthy Inventory for Men (SHIM) questionnaire. Incontinence was measured by patient-reported daily pad use. Univariate and multivariate analyses were performed. Outcomes were assessed at the most recent follow-up. RESULTS Among 213 patients eligible for inclusion, 27 experienced an anastomotic urine leak (12.7%). At a mean long-term follow-up of 24.2 months, there was no difference in SHIM scores (7.0 vs 13.1; P= 0.101), continence rates (87.5% vs 85.2%; P= 0.999) or risk of BNC (7.4% vs 3.2%; P= 0.268) between patients with and without postoperative anastomotic urine leaks, respectively. The results did not change after controlling for covariates in a multivariate analysis. CONCLUSION The present study suggests that patients with clinically detected postoperative anastomotic urine leaks do not necessarily have worse long-term outcomes of erectile function, continence and risk of BNC.
- bladder neck contracture
- erectile function
- robotic-assisted laparoscopic radical prostatectomy
- urine leakage
ASJC Scopus subject areas