Modified cystoscopy-assisted laparoscopic Y-V plasty for recalcitrant bladder neck contracture

Area of Science:

• Urology
• Surgical Innovation
• Minimally Invasive Surgery

Background:

• Bladder neck contracture (BNC) frequently complicates transurethral resection of the prostate.
• Recalcitrant BNC cases present a significant clinical challenge.
• Novel surgical approaches are needed for effective BNC management.

Purpose of the Study:

• To evaluate the outcomes of a modified cystoscopy-assisted laparoscopic Y-V plasty for treating recalcitrant bladder neck contracture.
• To assess the efficacy and safety of this minimally invasive technique.

Main Methods:

• Retrospective evaluation of 27 patients with recalcitrant BNC treated with modified cystoscopy-assisted laparoscopic Y-V plasty.
• Preoperative and postoperative assessment included urinary flow rate, International Prostate Symptom Score (IPSS), and cystoscopy.
• Data collected from January 2017 to September 2019 with a median follow-up of 14.2 months.

Main Results:

• The procedure was successfully completed in all patients without serious complications.
• Significant improvements observed in maximum urine flow rate (17.7 vs. 8.2 ml/s) and a decrease in IPSS (5.7 vs. 19.2) post-surgery (p < 0.05).
• Cystoscopy at 3 months revealed a wide bladder neck in 92.6% of patients, with no reported urinary incontinence.

Conclusions:

• Modified cystoscopy-assisted laparoscopic Y-V plasty is a safe and effective surgical option for recalcitrant bladder neck contracture.
• This technique demonstrates favorable functional outcomes and anatomical restoration.
• It represents a valuable advancement in managing complex BNC cases.