• Vassilis Poulakis, Konstantinos Skriapas, Rachelle de Vries, Wolfgang Dillenburg, Ulrich Witzsch, and Eduard Becht.
• Department of Urology and Pediatric Urology, Northwest Hospital, Stiftung Hospital zum Heiligen Geist, Frankfurt am Main, Germany.
• Urology. 2006 Dec 1; 68 (6): 1284-9.

ObjectivesTo determine the safety and efficacy of the single-knot running versus interrupted technique for urethrovesical anastomosis during endoscopic extraperitoneal radical prostatectomy.MethodsA total of 250 consecutive patients who underwent endoscopic extraperitoneal radical prostatectomy were prospectively divided into two groups of 125 patients each who underwent urethrovesical anastomosis using the single-knot running technique (group 1) or the interrupted suture technique (group 2). Surgical data, operative time, difficulty scores, extravasation rate, catheterization time, occurrence of anastomotic strictures, and the early and late continence rates were analyzed statistically.ResultsRegarding the clinical and pathologic findings, extravasation rate, catheterization time, and occurrence of anastomotic strictures, no significant differences were found between the two groups (P >0.05). The strongest independent predictors for extravasation were the integrity of the dorsal wall of the anastomosis and the degree of bladder neck opening (P <0.001). Overall, the continence rate at 3 and 6 months was 76% and 91.5% for group 1 and 77.6% and 93% for group 2, respectively (all P >0.05). The anastomosis technique had no impact on extravasation or continence status (all P >0.05). The only significant differences (P <0.001) in favor of the single-knot technique were the mean operative time and difficulty score (16 versus 24 minutes and 1 versus 3, respectively).ConclusionsBoth techniques provide satisfactory and similar functional results. However, because of its simplicity and shorter operative time, the single-knot running technique appears preferable.

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