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Related Experiment Videos

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
PubMed
Summary
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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.

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  • 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.