Early imaging characteristics and functional evaluation of bladder wall reconstruction neourethra after robot-assisted laparoscopic prostatectomy for prostate cancer
10.3969/j.issn.1009-8291.2024.07.009
- VernacularTitle:前列腺癌根治术膀胱壁重建新尿道的术后早期影像学特点及功能评价
- Author:
Zhenghui GUAN
1
;
Jie ZHAO
;
Xiaoying SHEN
;
Jiangping WANG
Author Information
1. 大连医科大学研究生院,辽宁大连 116000
- Keywords:
robot-assisted laparoscopic prostatectomy;
magnetic resonance imaging;
voiding cystourethrography;
bladder wall reconstruction neourethra;
urinary control
- From:
Journal of Modern Urology
2024;29(7):607-611
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the early imaging characteristics and function of bladder wall reconstruction neourethra(BWN)after robot-assisted laparoscopic prostatectomy(RALP)for prostate cancer with magnetic resonance imaging(MRI)and voiding cystourethrography(VCUG).Methods A total of 36 patients who underwent RALP using BWN technique at Taizhou People's Hospital during Mar.2021 and Jun.2023 were enrolled.Postoperative MRI was used to measure the length,wall thickness,and lumen shape of the new urethra.The morphology of the new urethra in 19 patients was observed under VCUG during the storage phase,voiding phase,and interrupted voiding phase.Results The patients'median age was 73.00 years(range:68.00 to 76.25),the prostate volume was(45.01±7.18)cm3,and the median total prostate-specific antigen(tPSA)level was 10.77 ng/mL(range:7.30 to 14.86).Two patients were classified as T1 stage,25 as T2,and 9 as T3.Gleason scores were ≤6 in 7 patients and ≥8 in 8 patients.Risk classification was low risk in 2 patients and high risk in 8 patients.Postoperatively,urinary control rates at 1,3,and 6 months were 91.67％,97.22％,and 100％,respectively.MRI revealed a median new urethra length of 15.13 mm(range:12.71 to 20.26)and a median wall thickness of 6.84 mm(range:6.18 to 8.20).The urethral lumen had a complete muscular layer and mucosal layer,which appeared petal-like.In patients with urinary incontinence,residual urine was visible in the new urethra and at the anastomosis site.Of the 19 patients who underwent VCUG,16 could close the new urethra during the storage and interrupted voiding phases,and open it during the voiding phase;3 could not close it well during the storage and interrupted voiding phases.Conclusion MRI and VCUG clearly demonstrate that the BWN technique can successfully create a new urethra with good functionality,which helps improve urinary control after RALP for prostate cancer.
