Access to urethral stump in radical prostatectomy - abstract

ABSTRACT

Prostatic carcinoma is the commonest cancer in the male and is now being more frequently diagnosed at an earlier and potentially curable state. The operation of radical prostatectomy offers the best chance of a cure and is therefore being more often used in preference to radiotherapy. Vesicourethral anastomosis is probably the most technically difficult part of this procedure as the urethral stump may not be clearly visible nor accessible. When poorly performed, anastomosis may contribute to the increased morbidity associated with extravasation, incontinence and stricture formation, and may negate the success of a nerve sparing operation. Visibility of and access to the urethral sphincteric stump may be greatly increased by placing a Foley catheter in the urethra with its tip protruding into the pelvis through the stump. With 8 ml of water inflating the balloon which lies under the perineal membrane, traction upwards elevates this stricture along with the urethral stump into the pelvis. The technique has been successfully used in eight (8) patients over the past year with no untoward complications (AU)