Management of urethral strictures and stenosis caused by the endo-urological treatment of benign prostatic hyperplasia—a single-center experience

Kore, Rajiv Nilkanth

doi:10.1016/j.ajur.2021.06.009

Cited by 1 publication

(1 citation statement)

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“…Some patients suffer from recurrent stenosis and its exact causes are not fully understood, but it is thought to be related to the surgical procedure itself, tissue healing, and patient factors. 3 There are a few single-center, low-volume studies addressing the outcomes of endoscopic treatment of BNS following TURP 4,5 and only one multicentre cohort. 6 This multicentre study aims to understand the nuances of management of BNS post-TURP in a real-world setting with regard to early and medium-term surgical outcomes and to analyze which are the common surgical approaches and energy mediums used to manage the same.…”

Section: Introductionmentioning

confidence: 99%

One-Year Outcomes of Transurethral Treatment of Bladder Neck Stenosis Following Transurethral Resection of the Prostate. Results from a Large, Multicenter Series

Castellani,

Stramucci,

Enganti

et al. 2024

IJGM

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To assess management and outcomes of bladder neck stenosis (BNS) post-transurethral resection of the prostate (TURP) in 12 centers. Patients and Methods: A retrospective analysis of patients who underwent transurethral BN incision for stenosis following TURP from January 2015 and January 2023 was performed. Inclusion criteria included endoscopic diagnosis of BNS associated with obstruction and/or lower urinary tract symptoms. Data are presented as median and interquartile range. Two distinct univariable logistic regression analyses were performed to identify factors associated with overall urinary incontinence and recurrent stenosis. Results: Three hundred and seventy-two men were included. 95.2% of patients developed BNS following bipolar TURP. 21.0% of patients were on an indwelling catheter before BNS incision. Bipolar electrocautery was the most commonly employed energy for incision (66.5%). Collings knife was the most commonly employed (61.2%) instrument for incision, followed by end-firing holmium lasering (35.3%). Median operation time was 30 (25-45) minutes. The overall complication rate was 12.4%, with 19 (5.1%) patients suffering from acute urinary retention, 6 (1.6%) patients requiring prolonged irrigation due to persistent hematuria, and a surgical hemostasis was necessary in 8 cases (2.2%). Overall postoperative incontinence rate was 17.2%, with urge incontinence accounting for the most common type (45.3%). Incontinence lasted more than 3 months in 9/46 (14.3%) patients. Recurrent BNS occurred in 29 (7.8%) patients and was managed by re-endoscopic incision in 21 (5.6%) patients and dilatation only in 6 (1.6%) patients. Two (0.5%) patients underwent urethroplasty for recalcitrant stenosis. Logistic regression analysis showed that Collings knife was associated with higher odds of having postoperative incontinence p=0.008) and BN recurrence p=0.047). Conclusion:Transurethral BN incision provides satisfactory short-term results with an acceptable rate of complications.

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