Transurethral Incision With Transverse Mucosal Realignment for the Treatment of Bladder Neck Contractures After...

Area of Science:

• Urology
• Surgical Innovation
• Endourology

Background:

• Bladder neck contracture (BNC) is a potential complication following benign prostatic hyperplasia (BPH) surgery.
• Existing treatments for BNC can have limitations, necessitating novel approaches.

Purpose of the Study:

• To evaluate the mid-term anatomic and functional outcomes of transurethral incision with transverse mucosal realignment (TUITMR).
• To assess TUITMR as a treatment for BNC specifically in patients who have undergone prior BPH surgery.

Main Methods:

• A retrospective review of a prospectively maintained registry of 92 patients undergoing TUITMR for BNC post-BPH surgery.
• Evaluation of primary outcomes including cystoscopic patency and freedom from reintervention.
• Assessment of secondary outcomes such as symptom scores, post-void residual, continence, and complications over a median follow-up of 15.9 months.

Main Results:

• High primary anatomic success rate of 93.5% was observed.
• 83.7% of patients remained free from reintervention after a single TUITMR procedure.
• Overall clinical success reached 93.5%, with final anatomic success of 96.7% after up to two procedures. No de novo incontinence was reported, and complications were predominantly minor.

Conclusions:

• TUITMR demonstrates high and durable anatomic and clinical success for treating BNC after BPH surgery.
• The procedure offers excellent salvage potential with repeat interventions and is associated with low morbidity.
• TUITMR represents a promising endoscopic solution for managing BNC in the BPH patient population.