S017: Our experience of implementing gil-vernet method about urine incontination after radical retropubic prostatectomy

S017: Our experience of implementing gil-vernet method about urine incontination after radical retropubic prostatectomy Pamporova I., Shopov A., Chitalov G., Zdravtchev S., Peev V. Medical University, Dept. of Urology, Plovdiv, Bulgaria INTRODUCTION & OBJECTIVES: The short brief of the problems connected with the urine incontination after radical prostatectomy, shows that these problems are not solved and the examinations are still actual. Aims & Tasks: To implement and investigate a new method for reducing the urine incontination after radical prostatectomy. MATERIAL & METHODS: From March 2011 to February 2014 we made retropubic prostatectomy in a new way for our practice in 14 patients with local advanced prostate adenocarcinoma /staging Т2 N0M0 / and Glisson score to 7. We made retropubic prostatectomy since 1998 as we have used different techniques: Progarde,retrograde, with resection and without resection of the puboprostate ligaments, with saving vessel-nerve shaft. In 1/3 of the cases we had stress incontinantion in different stages although of the operative technique. From 2011 we began to use intraoperative investigation of the urinary bladder continence before making bladder-urethral anastomosis, the same as Gil Vernet’s [Figure 1]. The main part of the manipulation consists of filling the urinary bladder with liquid by Nelaton catheter. The orifice of the urinary bladder we create around supported anatomic pincet and we narrow with stitches till there is no flow from the bladder after removing the pincet. There is a flow only by prssing the urinary bladder or putting an instrument inside it. After that we make bladder urethral anastomosis [Figures 2,3].

RESULTS: In 2 cases /14,3%/ we had urine incontinence. But we had obstruction if the level of bladder urethral anastomosis in 4 cases /28,6%/ - it was solved by transurethral resection. CONCLUSIONS: Manipulating the urinary bladder orifice to hold liquid inside the bladder before making bladder urethral anastomosis prevents incontinence after prostatectomy. Sclerosis of bladder urethral anastomosis is more often observed, but is easier to solve. It is needed more representativeness of the observations Eur Urol Suppl 2014; 13(7) e1421