New standardization of checking the vesicourethral XXXX for @entity3431 following radical prostatectomy with dynamic transrectal ultrasound: can this new technique replace the traditional postoperative cystogram?

@entity1 @entity11898 @entity3431 @entity254 @entity72306 @entity811
PURPOSE: Urinary extravasation at the @entity254 is common after radical prostatectomies. Nevertheless, no data exist referring to the optimal date of catheter removal at the time of expected complete @entity3431 of the leakage. Thus, we developed over the last 10 years a standardized concept to check the @entity254 , evaluating urinary extravasation using a dynamic transrectal ultrasound ( @entity72306 ). METHODS: From 1999 to 2008, 1,479 radical prostatectomies have been performed. For complete @entity3431 , 752 could be evaluated using the standardized concept of checking the @entity254 . The first 250 @entity1 have been evaluated by cystogram and @entity72306 and the following 502 @entity1 only by @entity72306 postoperatively. The date of checking the @entity254 was determined by the urine color. RESULTS: Urinary extravasation could be detected 4-8 days postoperatively in 41% (n = 308), 9-12 days in 16% (n = 120), 13-20 days in 8% (n = 60), and in no @entity1 after 21 days. The coefficient of correlation comparing @entity72306 versus cystogram was r = 0.99, P < 0.05. The measured volume of urinary extravasation after 4-8 days postoperatively was 15 ml (3-49 ml) using @entity72306 and 16 ml (3-45 ml) using cystogram. After 9-20 days, the volume was determined as 9 ml (3-24 ml) by @entity72306 and 9 ml (4-23 ml) by cystogram. The macroscopic evaluation of the urinary color was very well correlated with the likelihood of extravasation being still present. When the urine was cloudy or colored by old blood, extravasation was present in 96.9% of the @entity1 . Microscopic evaluation like leukocyturia or @entity811 of the urine on the same day shows specificity in only 34.3%. CONCLUSIONS: Following radical prostatectomy, the urine color is essential to assess the chance of a persisting leakage at the @entity254 . The method of @entity72306 can replace the cystogram in checking for complete healing of the @entity254 , thus decreasing the exposure to @entity11898 of the @entity1 of about 60 cGy/cm(2).
