Introduction
Prostate cancer (PCa), the most common cancer of men, accounts for approximately one third of all cancers in men.1Although there are treatment options such as high-intensity focused ultrasound, cryoablation and radiotherapy, the vast majority of men undergo open retropubic radical prostatectomy (RRP), which is the gold standard in the treatment of this disease.2 With the developing technique and technology, minimally invasive treatment methods have become popularized in urological oncological surgery. Robotic radical prostatectomy, which is one of these techniques, has revolutionized PCa surgical treatment with the benefits it provides to surgeons. However, the high cost of the robotic platform and the long learning curve of the laparoscopic technique prevented them from spreading globally, and in most centers, RRP is still the most performed technique.
In radical prostatectomy, it is of great importance to achieve optimal functional results in addition to oncological control. Vesicourethral anostomosis (VUA) technique affects significant complications such as colllum sclerosis and incontinence affecting the course of surgery results. Various modifications have been developed to optimize anostomosis and avoid those complications. In the past, Walsh, who has contributed greatly to the development of the RRP technique, proposed 6 focal sutures for VUA.3 Then, this technique was tried to be modified and the results of studies dealing with suturing sites, numbers and continuous suturing were published.4-6These techniques have been tried to be performed in laparoscopic and robotic techniques besides open technique. In addition to these modifications, a technique, in which a completely sutureless anostomosis was made, appeared in the literatüre.7 Their common goal was to optimize the functional results after VUA.
It is an undeniable fact that VUA technique affects important functional results, especially anostomosis stricture. There is no consensus in the literature on the optimal anostomosis technique and more studies are needed to clarify this issue. In this study, we aimed to evaluate the effect of two different VUA techniques that we frequently use in our clinic on functional outcomes.