The position of Urethrovesical Anastomosis after Robotic Rad
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MR measurements to determine anastomosis positioning after radical prostatectomy are reliable and have a strong correlation between readers. The final positioning of the uretrovesical anastomosis varies according to the type of reconstruction. The final positioning of the anastomosis is related to early urinary recovery: MRI parameters are independent predictors of urinary continence.

Functional and anatomical changes associated with prostate removal coincide with alterations in pelvic structures. The aim of this study was to determine magnetic resonance anatomic predictors of urinary recovery after radical prostatectomy, and to assess their relation to the type of reconstruction.

Forty patients were randomly selected from a trial. Two independent radiologists determined the situation of the anastomosis in the pelvis according to MRI performed a month after the radical prostatectomy: vertical situation assessed as the distance to the line coccyx-inferior pubic margin (ACPv) and anteroposterior situation as the distance from the pubis (Distance A), and from the coccyx (Distance B).

--The Pearson correlation of ACPv, Distance A, and B between readers were 0.975, 0.940, and 0.711, p?<?0.001.

--Patients with the reconstruction presented more cephalic situation of the anastomosis (higher ACPv) than patients with standard reconstruction technique.

--A multivariate analysis was performed including age, BMI, prostate volume, PRRS, and the MRI parameters.

--ACPv and Distance B were the only two independent predictors of no need for any urinary protection at 6 months after the surgery.

Conclusively, positional differences according to the type of reconstruction after radical prostatectomy related to early urinary recovery. Magnetic resonance measurements to determine anastomosis positioning are reliable and have a strong correlation between readers. Anatomic MRI features are independent predictors of urinary recovery after robotic radical prostatectomy.

European Journal of Radiology
Source: https://doi.org/10.1016/j.ejrad.2021.109589
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