The impact of urinary extravasation after radical retropubic prostatectomyon urinary incontinence and anastomotic strictures

Objective: The aim of this study was to determine the relevance of urinary extravasation as proven by cystogram 18 days after radical retropubic prost atectomy for the degree of postoperative urinary incontinence and the incid ence of anastomotic strictures. Patients and Methods: A total of 225 patien ts underwent radical retropubic prostatectomy at our institution during a 3 0-month period, 215 of whom received a cystogram a mean 18 days following s urgery. Three and 6 months after surgery these 215 patients were evaluated regarding the degree of urinary incontinence and the presence of anastomoti c strictures. Results: The cystogram demonstrated a watertight anastomosis in 89% (n = 195; group I), the remaining 11% (n = 24; group II) showed urin e extravasation. Groups I and It were comparable with respect to age, preop erative serum levels of prostate-specific antigen (PSA), tumor grade and pa thological staging. Six months after surgery, there was no statistically si gnificant (p > 0.05) difference between both groups regarding the degree of urinary incontinence and the presence of anastomotic strictures. Conclusio ns: The presence of urine extravasation 18 days after radical retropubic pr ostatectomy has no impact on postoperative urinary incontinence and the inc idence of anastomotic strictures. Based on these data it is not indicated t o leave the catheter in situ beyond that point of time.