METHOD OF URINARY BLADDER NECK FORMING WHEN PERFORMING THE VESICO-URETHRAL ANASTOMOSIS AFTER RETROPUBIC PROSTATECTOMY

摘要

FIELD: medicine.;SUBSTANCE: invention relates to medicine, specifically to urology. Before suturing directly on the neck of the urinary bladder, visualize the mouths of both ureters through the hole in the neck of the urinary bladder to control the intake of urine and exclude the possibility of getting the latter into the seam. Suturing of the defect of the wall of the bladder through all the layers is made without eversion of the mucosa of the bladder to a distance of 1–2 cm distal to the ureteral orifices, in the dorsal direction, starting from the distal edge of the resected neck of the urinary bladder, from its ventral surface with a continuous atraumatic suture. Evacuate the mucosa of the bladder and in the first part of the seam grab all the walls of the bladder except the mucous membrane. Then, before each subsequent puncture, the needles are picked up separately by the mucous membrane, making the injection of the needle deeper into the submucosal layer, turning the mucous membrane, form a hole with a diameter of 20 (on the scale of Charrier) with eversion of the mucosa and continue to apply a continuous seam front-to-back in the opposite direction, picking up in the first portion of the seam the advent of the bladder and paravesical fiber. In the second part of the seam, all the layers of the wall are picked up, forming the second row of seams to the first initial point of the prong, the yarns are tied together, the knot is positioned distally and posteriorly from the zone of formation of the vesico-urethral anastomosis.;EFFECT: method reduces the risk of development of anastomosis failure and its stricture due to more anatomical comparison of the mucous membrane of the urethra and bladder.;1 cl, 1 ex, 18 dwg