Salvage prostatectomy with continent catheterizable urinary reconstruction: A novel approach to recurrent prostate cancer after radiation therapy

Louis L. Pisters, Sharon F. English, Shellie M. Scott, Ouida L. Westney, Colin P.N. Dinney, Edward J. McGuire

Research output: Contribution to journalArticle

44 Scopus citations

Abstract

Purpose: Salvage prostatectomy after full dose radiation therapy is associated with a high risk of urinary incontinence. We evaluated the complications of salvage prostatectomy with continent catheterizable reconstruction and its impact on urinary incontinence. Materials and Methods: Between August 1995 and February 1999, 13 patients with biopsy proved, locally recurrent prostate cancer after radiation therapy underwent salvage prostatectomy with complete bladder neck closure and reconstruction with an appendicovesicostomy to the native bladder in 9 and ileovesicostomy in 4. Results: There were no intraoperative complications. Four patients had serious complications necessitating reoperation, including a vesicourethral fistula requiring delayed cystectomy, wound dehiscence with disruption of the appendicovesical anastomosis, leakage from the small bowel anastomosis that resulted in sepsis and death, and stomal stenosis requiring delayed stomal revision in 1 each. Of 12 patients 2 (17%) used pads for incontinence, while 10 were dry during the day and night with a catheterization interval of 2 to 6 hours. Conclusions: Salvage prostatectomy with continent catheterizable reconstruction is a technically challenging operation with the potential for serious complications. The postoperative continence rate is excellent and appears superior to those in the literature for salvage prostatectomy and vesicourethral anastomosis.

Original languageEnglish (US)
Pages (from-to)1771-1774
Number of pages4
JournalJournal of Urology
Volume163
Issue number6
DOIs
StatePublished - Jan 1 2000

Keywords

  • Prostate
  • Prostatectomy
  • Prostatic neoplasms
  • Radiotherapy
  • Urinary diversion

ASJC Scopus subject areas

  • Urology

Fingerprint Dive into the research topics of 'Salvage prostatectomy with continent catheterizable urinary reconstruction: A novel approach to recurrent prostate cancer after radiation therapy'. Together they form a unique fingerprint.

Cite this