Bridging the gap: use of scaffolding tissue bio-grafts to bolster vesicourethral anastomosis during salvage robot-assisted prostatectomy reduced leak rates and catheter times

Rajesh Nair, Kamran Zargar-Shoshtari, Homayoun Zargar


Salvage Robot Assisted Radical Prostatectomy (sRARP) for recurrent prostate cancer is considered a higher risk procedure due to its inherent risk of increased intra- and post operative complications. Of note, vesicourethral anastomosis (VUA) leak can occur in up to one third of cases (1). Contributing factors are often attributed to prior therapy and include increased tissue friability and postoperative necrosis, and despite efforts to ensure a high quality of surgical anastomosis, poor surrounding tissue quality can result in anastomosis disruption (2). The deleterious effects of a VUA leak are numerous; urethral stricture formation, bladder neck contracture, urinary peritonitis and paralytic ileus. In addition, prolonged urethral catheterization or drain placement can result in secondary infection, protracted inpatient hospital stay or necessitate a second reconstructive procedure.