Bipolar Transurethral Incision of Bladder Neck Stenoses with Mitomycin C Injection

Lyon, Timothy D.; Ayyash, Omar; Ferroni, Matthew C.; Rycyna, Kevin J.; Chen, Mang L.

doi:10.1155/2015/758536

Cited by 14 publications

(14 citation statements)

References 15 publications

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“…Vanni et al retrospectively reviewed 18 patients with recurrent BNC, who underwent cold knife BNI and MMC injection and reported stabilization of the BNC in 72% after a single intervention and 89% after 2 interventions, with a median follow-up of 12 months and minimal morbidity reported ( 48 ). Lyon et al performed a similar retrospective analysis of 13 patients, with stabilization in 62% ( 49 ). The TURNS study group looked retrospectively at 66 patients of whom 80% had previously failed a dilatation or BNI.…”

Section: Managementmentioning

confidence: 99%

Management of bladder neck stenosis and urethral stricture and stenosis following treatment for prostate cancer

Nicholson

Al-Hakeem

Maldonado

et al. 2017

Transl. Androl. Urol.

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The aim of this review is to examine all urethral strictures and stenoses subsequent to treatment for prostate cancer, including radical prostatectomy (RP), radiotherapy, high intensity focused ultrasound (HIFU) and cryotherapy. The overall majority respond to endoscopic treatment, including dilatation, direct visual internal urethrotomy (DVIU) or bladder neck incision (BNI). There are adjunct treatments to endoscopic management, including injections of corticosteroids and mitomycin C (MMC) and urethral stents, which remain controversial and are not currently mainstay of treatment. Recalcitrant strictures are most commonly managed with urethroplasty, while recalcitrant stenosis is relatively rare yet almost always associated with bothersome urinary incontinence, requiring bladder neck reconstruction and subsequent artificial urinary sphincter (AUS) implantation, or urinary diversion for the devastated outlet.

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Section: Managementmentioning

confidence: 99%

Management of bladder neck stenosis and urethral stricture and stenosis following treatment for prostate cancer

Nicholson

Al-Hakeem

Maldonado

et al. 2017

Transl. Androl. Urol.

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“…Chen et al . report similar success rates for initial treatment when using bipolar incisions when compared with “cold” urethrotomy 54 . Meanwhile, Ali and Ahmad et al .…”

Section: Managementmentioning

confidence: 79%

Advances in urethral stricture management

Gallegos

Santucci

2016

F1000Res

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Urethral stricture/stenosis is a narrowing of the urethral lumen. These conditions greatly impact the health and quality of life of patients. Management of urethral strictures/stenosis is complex and requires careful evaluation. The treatment options for urethral stricture vary in their success rates. Urethral dilation and internal urethrotomy are the most commonly performed procedures but carry the lowest chance for long-term success (0–9%). Urethroplasty has a much higher chance of success (85–90%) and is considered the gold-standard treatment. The most common urethroplasty techniques are excision and primary anastomosis and graft onlay urethroplasty. Anastomotic urethroplasty and graft urethroplasty have similar long-term success rates, although long-term data have yet to confirm equal efficacy. Anastomotic urethroplasty may have higher rates of sexual dysfunction. Posterior urethral stenosis is typically caused by previous urologic surgery. It is treated endoscopically with radial incisions. The use of mitomycin C may decrease recurrence. An exciting area of research is tissue engineering and scar modulation to augment stricture treatment. These include the use of acellular matrices or tissue-engineered buccal mucosa to produce grafting material for urethroplasty. Other experimental strategies aim to prevent scar formation altogether.

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“…Most of these patients have recalcitrant/recurrent non-obliterative VUAS/BNS [ 76 , 77 ]. Reported patency rates with steroid injections range from 50% to 79%, all patients did not require self-dilatation after a maximum of two procedures [ 78 , 79 , 80 , 81 , 82 , 83 ].…”

Section: Managementmentioning

confidence: 99%

Devastated Bladder Outlet in Pelvic Cancer Survivors: Issues on Surgical Reconstruction and Quality of Life

Martins

Holm

Lumen

2021

JCM

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Bladder outlet obstruction following treatment of pelvic cancer, predominantly prostate cancer, occurs in 1–8% of patients. The high incidence of prostate cancer combined with the long-life expectancy after treatment has increased concerns with cancer survivorship care. However, despite increased oncological cure rates, these adverse events do occur, compromising patients’ quality of life. Non-traumatic obstruction of the posterior urethra and bladder neck include membranous and prostatic urethral stenosis and bladder neck stenosis (also known as contracture). The devastated bladder outlet can result from benign conditions, such as neurogenic dysfunction, trauma, iatrogenic causes, or more frequently from complications of oncologic treatment, such as prostate, bladder and rectum. Most posterior urethral stenoses may respond to endoluminal treatments such as dilatation, direct vision internal urethrotomy, and occasionally urethral stents. Although surgical reconstruction offers the best chance of durable success, these reconstructive options are fraught with severe complications and, therefore, are far from being ideal. In patients with prior RT, failed reconstruction, densely fibrotic and/or necrotic and calcified posterior urethra, refractory incontinence or severe comorbidities, reconstruction may not be either feasible or recommended. In these cases, urinary diversion with or without cystectomy is usually required. This review aims to discuss the diagnostic evaluation and treatment options for patients with bladder outlet obstruction with a special emphasis on patients unsuitable for reconstruction of the posterior urethra and requiring urinary diversion.

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Bipolar Transurethral Incision of Bladder Neck Stenoses with Mitomycin C Injection

Cited by 14 publications

References 15 publications

Management of bladder neck stenosis and urethral stricture and stenosis following treatment for prostate cancer

Management of bladder neck stenosis and urethral stricture and stenosis following treatment for prostate cancer

Advances in urethral stricture management

Devastated Bladder Outlet in Pelvic Cancer Survivors: Issues on Surgical Reconstruction and Quality of Life

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