COMPARISON OF THE MODIFIED VEST AND THE DIRECT ANASTOMOSIS FOR RADICAL RETROPUBIC PROSTATECTOMY

Objectives. This retrospective study was undertaken to compare the eff icacy of the Vest and direct vesicourethral anastomosis for radical pr ostatectomy. Methods, Five hundred six patients who underwent consecut ive radical prostatectomies at our institution were analyzed. Two hund red fifty-nine patients underwent vesicourethral anastomosis using the Vest technique and 247 underwent a direct suture anastomosis. The gro ups were analyzed relative to time until healing, the occurrence of an astomotic strictures, and the continence rate 1 year after surgery. Re sults. Approximately twice as many patients who underwent the Vest pro cedure experienced delayed healing and 8.5% developed anastomotic stri ctures compared with 1.2% of the direct anastomosis group. The Vest gr oup experienced slightly better urinary continence 1 year postoperativ ely. Conclusions, The Vest procedure is a reasonable alternative to di rect anastomosis for radical prostatectomy and provides similar result s. We suggest specific circumstances when the Vest anastomosis may be particularly useful. (C) 1997, Elsevier Science Inc.