Influence of conventional versus unidirectional barbed suture on leakage pressures in canine vesicourethral anastomosis: An ex-vivo study.

Abstract

OBJECTIVE: To compare leakage pressures of vesicourethral anastomosis (VUA) performed with conventional and unidirectional barbed sutures in canine cadaveric tissue. STUDY DESIGN: Experimental, ex-vivo, randomized study. ANIMALS: A total of 24 male canine bladders with the urethra. METHODS: Specimens after prostatectomy were randomly divided into a unidirectional barbed suture (UBS) or a conventional suture (C) group. For the UBS group, the VUA was performed with 4-0 unidirectional barbed sutures. For the C group, the VUA was performed with 4-0 monofilament absorbable suture. The VUA was completed with two simple continuous sutures. Surgical time, leakage pressure, site of leakage, and the number of suture bites were recorded. RESULTS: The median suturing time was 12.70&#x2009;minutes (range: 7.50-16.10&#xa0;min) for the UBS group and 17.30&#x2009;minutes (range: 14.00-21.30&#x2009;min) for the C group (p&#x2009;<&#x2009;.0002). The median leakage pressure was 8.60&#x2009;mmHg (range: 5.00-17.20&#x2009;mmHg) for the UBS group and 11.70&#x2009;mmHg (range: 6.00-18.50&#x2009;mmHg) for the C group (p&#xa0;=&#xa0;.236). The median number of suture bites was 14 (range:11-27) for the UBS group and 19 (range:17-28) for the C group (p&#xa0;=&#xa0;.012). CONCLUSION: Unidirectional barbed suture does not statistically affect the acute leakage pressure of VUA in normal cadaveric specimen. It resulted in a shorter surgical time and fewer suture bite placements. CLINICAL SIGNIFICANCE: A urinary catheter will still be required when a unidirectional barbed suture is used to complete a VUA in dogs to prevent extravasation of urine in the postoperative period.