A Preliminary Study On The Effect Of Double-needle Barbed Cystourethral Anastomosis In Laparoscopic Radical Prostatectomy On The Recovery Of Urinary Control In Early Postoperative Period

Objective: To analyze the rate of early urinary continence after laparoscopic radical prostatectomy in urethrovesical anastomosis(UVA)with double-needle barbed suture.Methods: The datas of 54 cases of laparoscopic radical prostatectomy in our department from January 2013 to December 2019 were retrospectively analyzed,27 cases of the double-needle barbed suture group and 27 cases of the single-needle continuous suture group for UVA.Age,body mass index(BMI),prostate volume,prostate-specific antigen(PSA)level,operative time,anastomosis time,estimated blood loss,Gleason score,number of hospitalization days,and urinary continence at postoperative month 1,3,6,and 12 were analyzed statistically.Results: There were no significant differences in age,BMI,prostate volume,PSA level,Gleason score,and indwelling catheter time between the two groups.However,bidirectional barbed suture was associated with a significantly shorter anastomosis time(P = 0.007),operation time(P = 0.008)and hospitalization duration(P < 0.001),and a significantly lower blood loss volume(P = 0.005).In terms of postoperative urinary control rate,the urine control rates of the double-needle barbed suture group at 1 month and 3 months after the operation were 56% and 85%,respectively,which were significantly better than those of the single-needle continuous suture group at 19% and41%,with statistically significant differences(P= 0.005,P = 0.001).The urine control rate at 6 months and 1 years after surgery was 93% and 100% in the double-needle barbed suture group and 78% and 93% in the single-needle continuous suture group,with no statistical significance.Multivariate regression analysis showed that anastomosis time(HR = 0.636;P<0.001)was an independent predictor of postoperative continence.Conclusions: The current findings show that bidirectional barbed suture for UVA during LRP can shorten UVA time and provide better outcomes in terms of early urinary continence recovery.