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Bladder neck contracture after radical retropubic prostatectomy
Dler Besarani1, Peter Amoroso, Roger Kirby
1The London Clinic, London, UK. dler@doctors.org.uk
BJU International
|December 22, 2004
Summary
Vesico-urethral anastomotic strictures occur in 9.4% of patients after bladder-neck sparing radical retropubic prostatectomy (RRP). Graduated dilatation is an effective treatment for these strictures.
Area of Science:
- Urology
- Surgical Oncology
Background:
- Radical retropubic prostatectomy (RRP) is a common treatment for prostate cancer.
- Bladder-neck sparing techniques aim to preserve urinary function.
- Vesico-urethral anastomotic strictures are a potential complication following RRP.
Purpose of the Study:
- To determine the incidence of vesico-urethral anastomotic strictures after bladder-neck sparing RRP.
- To evaluate the management strategies for these strictures.
- To assess the outcomes of stricture treatment.
Main Methods:
- A cohort of 510 patients undergoing open RRP by a single surgeon between 1994 and 2003 was retrospectively reviewed.
- Data on the incidence, management, and outcomes of anastomotic strictures were collected.
- Mean follow-up duration was 30 months.
Main Results:
- The incidence of vesico-urethral anastomotic strictures was 9.4% (48 out of 510 patients).
- Graduated dilatation of the stricture was the primary treatment modality.
- This treatment was effective, with a low requirement for further interventions.
Conclusions:
- Vesico-urethral anastomotic stricture is a relatively frequent complication after bladder-neck sparing RRP.
- Graduated dilatation under light sedation is a successful management approach.
- Most patients can be effectively treated with a single dilatation procedure.