Van Velthoven single-knot running suture versus Chlosta’s running suture versus single barbed suture V-Loc for vesicourethral anastomosis in laparoscopic radical prostatectomy: a retrospective comparative study

Introduction
The quality of vesicourethral anastomosis (VUA) in laparoscopic radical prostatectomy (LRP) is associated with complications that could significantly affect quality of life. Aim: To compare different types of sutures (Chlosta’s versus Van Velthoven versus V-Loc), used for VUA in LRP in terms of complication rates and continence recovery.

Material and methods
Patients who underwent LRP between 2014 and 2018 in a tertiary center were enrolled in the study. Data were extracted from medical records. Urinary continence was assessed at 3, 6, 12 and 18 months after LRP. Propensity score weighted regression models were used to estimate the effect of sutures on outcomes.

Results
A sample of 504 patients was analyzed, of which 109 patients underwent Chlosta’s suture VUA, 117 patients had Van Velthoven suture VUA, and 278 patients had V-Loc VUA. Median time of anastomosis was 13 (IQR – interquartile range: 10–16) min using Chlosta’s suture, 28 (IQR: 24–30) using Van-Velthoven suture and 12 (IQR: 11–16) min using V-Loc suture (p < 0.001). There were no significant differences between groups concerning complications and urinary continence at 12 and 18 months after surgery. The time of urinary continence recovery was on average 19 days (95% CI: 5–33) and 31 days (95% CI: 16–45) shorter during 1 year of observation when the V-Loc suture was used compared to the Van-Velthoven and Chlosta’s suture, respectively.

Conclusions
The study showed comparable results considering urinary continence recovery at 12 and 18 months after LRP in all VUA groups. Van Velthoven VUA was more time-consuming and continence recovery was faster in the V-Loc group.