Nontraumatic posterior urethral stenosis

Area of Science:

• Urology
• Surgical Oncology
• Reconstructive Urology

Background:

• Posterior urethral strictures and contractures are significant complications following treatments for benign prostatic hyperplasia (BPH), prostate cancer (PCa), and orthotopic neobladder creation.
• These conditions negatively impact patient prognosis and functional outcomes, highlighting a critical area of concern in urological care.

Purpose of the Study:

• To comprehensively review and identify factors influencing the etiology, prevention, and treatment of non-traumatic posterior urethral strictures and contractures.
• The study aims to consolidate current knowledge to improve management strategies for these challenging post-procedural complications.

Main Methods:

• A systematic review of published evidence was conducted using the PubMed database.
• Included studies encompassed English and Spanish literature, featuring cohort studies, case series, prospective/retrospective studies, and review articles focusing on PCa treatment, BPH therapies, and neobladder formation.

Main Results:

• Non-traumatic posterior urethral strictures and contractures are prevalent, contributing to substantial patient morbidity and diminished voiding quality.
• Preventative measures include meticulous surgical and radiotherapeutic techniques. Initial management often involves endoscopic therapies, with complex urethroplasties frequently necessary for definitive treatment.
• Urinary incontinence is a significant sequela, potentially requiring interventions such as artificial sphincters.

Conclusions:

• Non-traumatic posterior urethral strictures represent critical complications that can jeopardize the success of initial treatments.
• Management may necessitate intricate surgical interventions, with a notable risk of subsequent urinary incontinence, underscoring the need for specialized care and follow-up.