Volume 71, Issue 5, Pages (May 2017)

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Volume 71, Issue 5, Pages 822-830 (May 2017) Advanced Reconstruction of Vesicourethral Support (ARVUS) during Robot-assisted Radical Prostatectomy: One-year Functional Outcomes in a Two-group Randomised Controlled Trial Vladimir Student, Ales Vidlar, Michal Grepl, Igor Hartmann, Eva Buresova, Vladimir Student European Urology Volume 71, Issue 5, Pages 822-830 (May 2017) DOI: 10.1016/j.eururo.2016.05.032 Copyright © 2016 European Association of Urology Terms and Conditions

Fig. 1 Anatomic structures involved in the reconstruction phase. NVB=neurovascular bundle. European Urology 2017 71, 822-830DOI: (10.1016/j.eururo.2016.05.032) Copyright © 2016 European Association of Urology Terms and Conditions

Fig. 2 (A) Control group. Suture of the Denonvilliers fascia and bladder to the median dorsal raphe according to Rocco. (B) In the intervention group, we used an absorbable monofilament barbed V-loc 2/0 suture, which we led first to the right, across the medial levator ani muscle, then through the Denonvilliers fascia without injuring the neurovascular bundles. (C) The stitch goes over the bundles of the left medial levator ani and back to the Denonvilliers fascia. (D) The end of the stitch is passed under the urethra through the median dorsal raphe. (E) The suture is passed back through the detrusor under the bladder neck through the retrotrigonal layer. (F) In the last step, the needle is passed through the bladder neck and urethra to align them. European Urology 2017 71, 822-830DOI: (10.1016/j.eururo.2016.05.032) Copyright © 2016 European Association of Urology Terms and Conditions

Fig. 3 (A) The beginning of the tension-free anastomosis. (B) Frontal view of the completed tension-free anastomosis. (C) The arcus tendineus is sutured to the bladder neck in both groups. European Urology 2017 71, 822-830DOI: (10.1016/j.eururo.2016.05.032) Copyright © 2016 European Association of Urology Terms and Conditions

Fig. 4 Study flow diagram. European Urology 2017 71, 822-830DOI: (10.1016/j.eururo.2016.05.032) Copyright © 2016 European Association of Urology Terms and Conditions