Managing urine leakage following laparoscopic radical prostatectomy with active suction of the prevesical space

Milan Hora; Petr Stránský; Jiří Klečka; Ivan Trávníček; Tomáš Ürge; Viktor Eret; Jiří Ferda; Fredrik Petersson; Ondřej Hes

doi:10.5114/wiitm.2011.31533

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abstract:

Original paper

Managing urine leakage following laparoscopic radical prostatectomy with active suction of the prevesical space

Milan Hora

,

Petr Stránský

,

Jiří Klečka

,

Ivan Trávníček

,

Tomáš Ürge

,

Viktor Eret

,

Jiří Ferda

,

Fredrik Petersson

,

Ondřej Hes

Videosurgery Miniinv 2013; 8 (1): 49-54

DOI: https://doi.org/10.5114/wiitm.2011.31533

Online publish date: 2012/10/30

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Introduction: Urine leakage following laparoscopic radical prostatectomy (LRP) is a possible complication that may herald chronic urine incontinence. Intraoperative measures aiming to prevent this is not standardised.

Aim: Presentation of experience with active suction of the prevesical space in managing postoperative urine leakage.

Material and methods: At the Department of Urology, where laparoscopy of the upper abdomen and open RP were performed, a protocol for extraperitoneal LRP was established in 8/2008. Until 5/2011, 154 LRPs have been performed. Urine leakage from a suction drain appeared in 9 cases (5.8%). Permanent active suction (with a machine for Büllae thoracic drainage) of the prevesical space with negative pressure of 7-12 cm of H₂O was started immediately.

Results: Urine leakage started after a mean of 0.9 (0-2) days postoperatively and stopped after a mean of 8.1 (15-42) days. Leakage stopped with only suctioning in 7 cases. In one case, open re-anastomosis was performed on the 7th postoperative day (POD). In another case, ineffective active suction was replaced on the 10^th POD by needle vented suction without effect and the leakage stopped following gradual shortening of the drain up to the 15th POD.

Conclusions: Active suction of the prevesical space seems to be an effective intervention to stop postoperative urine leakage after laparoscopic radical prostatectomy.

keywords:

Managing urine leakage following laparoscopic radical prostatectomy with active suction of the prevesical space

Milan Hora , Petr Stránský , Jiří Klečka , Ivan Trávníček , Tomáš Ürge , Viktor Eret , Jiří Ferda , Fredrik Petersson , Ondřej Hes

prostate cancer, radical prostatectomy, laparoscopy, complications, urinary leakage

Milan Hora

,

Petr Stránský

,

Jiří Klečka

,

Ivan Trávníček

,

Tomáš Ürge

,

Viktor Eret

,

Jiří Ferda

,

Fredrik Petersson

,

Ondřej Hes