BACKGROUND: Transurethral incision of the bladder neck is one of the main methods of correction of bladder neck stenosis that occurred after treatment of patients with benign prostatic hyperplasia. This technique involves endoscopic dissection in the area of the stenosed area without removing scar tissue. Taking into account the emergence of new reconstructive methods of surgical intervention in patients with recurrent bladder neck stenosis the expediency of using transurethral incision of the bladder neck in recurrent cases remains a subject of discussion. AIM: The aim of the study is to evaluate the effectiveness of the use of transurethral incision of the bladder neck in patients with recurrent bladder neck stenosis. MATERIALS AND METHODS: The study included 30 patients with a diagnosis of recurrent bladder neck stenosis who were treated in the period from 2012 to 2022. in Clinical Hospital of St. Luke and was performed transurethral incision of the bladder neck using bipolar electrosurgical energy. The diagnosis of bladder neck stenosis was established on the basis of complaints, anamnesis, uroflowmetry with determination of the volume of residual urine, ureteroscopy, retrograde urethrography. Recurrence was recorded when the maximum urination rate below 12 ml/s, there was an episode of acute urinary retention, or the need for additional surgical intervention for bladder outlet obstruction. RESULTS: All 30 patients underwent transurethral incision of the bladder neck using bipolar electrosurgical energy. The average duration of surgery was 22.9 minutes. The degree of postoperative complications did not exceed grade II according to the Clavien scale. The frequency of de novo stress urinary incontinence was detected only in one patient, which resolved spontaneously within 6 weeks. The maximum urination rate after 3 months was 14.73 3.61 ml/s, while after 6 months there was a significant decrease to 10.91 6.92 ml/s, and after 12 months to 9.4 7, 65 ml/s. The absence of recurrence in patients after TUI BN during the observation period was noted in 17 (56.67%) patients. CONCLUSIONS: Transurethral incision of the bladder neck using a bipolar electrode is a safe method for correcting bladder neck stenosis, but in recurrent cases it has limited efficacy. In this regard, in patients with a large number of endoscopic interventions in history, other methods of bladder neck reconstruction should be chosen.

Introduction. Bladder neck stenosis (BNS) is a late complication of surgical treatment for benign prostatic hyperplasia. Available methods of endoscopic correction in primary BNS have limited effectiveness, while in recurrent cases their use does not lead to satisfactory results at all. YV-plasty of the bladder neck (BN) is one of the available methods of treatment for recurrent BNS.Purpose of the study. To evaluate the treatment results of patients with recurrent BNS using endovideoscopic YV-plasty of the BN.Materials and methods. We retrospectively analyzed the treatment results of 8 patients with recurrent BNS who underwent endovideoscopic YV-plasty of the BN in the Urology Division No.1 of the St. Luke St. Petersburg Clinical Hospital from 2019 to 2021.Results. Endovideoscopic YV-plasty of the bladder neck was successfully performed in all 8 patients. The mean preoperative Qmax was 3.7 ml/s (1.8 – 5.7). At 6 months after surgery, the mean Qmax was 21.4 mL/s (16.7 – 24.1). The mean preoperative I-PSS score was 20.5 (17 – 24). The mean I-PSS score 6 months after surgery was 7.1 (5.0 – 9.0). No cases of de-novo stress urinary incontinence were registered.Conclusions. Endovideoscopic YV-plasty of the BN may be an effective and safe method of treatment of patients with recurrent BNS. However, further studies are needed to obtain long-term results.

Introduction. With the development of modern technologies and treatment methods of benign prostatic hyperplasia (BPH), there is an increase in the number of operations performed for this disease. In this regard, the absolute number of complications is also growing. Bladder neck stenosis (BNS) is one of those complications. The purpose of this review is to update information about currently available methods of treatment of BNS and their effectiveness. Materials and methods. 352 articles from the PubMed database, the scientific electronic library elibrary.ru and the websites of professional urological associations were analyzed. After processing the data, 37 articles and one practical guide were selected for the review. Results. Chronic diseases that contribute to the violation of microcirculation in the area of bladder neck (BN) (diabetes mellitus, atherosclerosis), smoking are predisposing factors for the development of BNS. A small volume of the prostate (less than 30 ml) is an independent risk factor and requires special attention when choosing a treatment method for patients with BPH. The amount of thermal exposure to the BN area during surgery affects the degree of microcirculation disturbance and, accordingly, the risk of BNS. Endoscopic methods of correction of BNS have moderate effectiveness in its primary occurrence and low effectiveness in recurrent cases. Reconstructive methods of correction of BNS shown to be highly effective in recurrent cases. Conclusion. Etiopathogenesis of BNS is multifactorial and depends on endogenous and exogenous factors. Treatment options for BNS range from simple outpatient procedures to complex reconstructive interventions. Each of the treatment methods should be considered individually for each patient, taking into account the characteristics of the patient’s history.

Introduction. Despite advances in therapy, esophageal cancer (EC) is recently became one of most incurable cancers, especially when it leads to dysphagia. Hence there is a need for develop the optimum management options. Aim. This study presents the experience of treating 464 patients with inoperable stages of esophageal cancer. The causes of inoperable behavior in this type of patients have been identified. Methods. A total of 249 patients were subjected to the following various options of minimally invasive interventions: endoscopic diathermotunnelization (EDT) in 38 (15.3%), endoscopic bougienage (EB) in 18 (7.2%) and endoscopic stenting (ES) in 193 (77.5%) patients. Results. Improved methods of minimally invasive interventions, as well as the nature of possible complications during their use were presented. Conclusion. It is concluded that the installation of endoscopic stenting with self-expanding metal stents (SEMS) with an antireflux valve in the treatment of non-operable EC stages with dysphagia syndrome is the most safe, effective and fast treatment method for dysphagia relief with a greater efficiency and the less frequency of complications especially when conventional silicone and rigid stents is used.

ntroduction. Bladder neck stenosis (BNS) is one of the most formidable and difficult to correct complications of transurethral surgical interventions on the prostate. Despite the significant progress in endourology and the abundance of new technological solutions used in transurethral surgery, the results of endoscopic correction of BNS are still unsatisfactory. One of the methods of correction of recurrent BNS is robot-assisted YV-plastic surgery of the BNS. Materials and methods. From 2021 to 2022, 30 robot-assisted modified YV-plastic bladder necks in patients with recurrent bladder neck stenosis were performed in St. Petersburg State Medical Institution «St. Luke's Clinical Hospital». Conclusion. The robot-assisted YV plastic in the presented modification has a high degree of efficiency and safety in recurrent bladder neck stenosis.