WITHDRAWN: Prerectal-transperineal approach for treatment of recurrent vesico-urethral anastomotic stenosis after radical prostatectomy

Antonio, Vitarelli; Vulpi, M.; Divenuto, Lucia; Papapicco, Giuseppe; Pagliarulo, Vincenzo; Ditonno, Pasquale

doi:10.1016/j.ajur.2021.05.009

Cited by 2 publications

(5 citation statements)

References 20 publications

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“…40 Open VUAS or bladder neck reconstruction can be performed retropubically or perineally with patency rates ranging from 70-100%. [42][43][44] In patients continent of urine preoperatively who had a retropubic approach, 10% were incontinent post-operatively, while those who had a perineal reconstruction had an 83.3% incontinence rate post-operatively. 42,43 Special Circumstances 30.…”

Section: Guideline Statementsmentioning

confidence: 99%

“…42-44 In patients continent of urine pre-operatively who had a retropubic approach, 10% were incontinent post-operatively, while those who had a perineal reconstruction had an 83.3% incontinence rate post-operatively. 42,43…”

Section: Guideline Statementsmentioning

confidence: 99%

“…[42][43][44] In patients continent of urine preoperatively who had a retropubic approach, 10% were incontinent post-operatively, while those who had a perineal reconstruction had an 83.3% incontinence rate post-operatively. 42,43 Special Circumstances 30. In men who require chronic selfcatheterization (eg, neurogenic bladder), surgeons may offer urethroplasty as a treatment option for urethral stricture causing difficulty with intermittent selfcatheterization.…”

Section: Guideline Statementsmentioning

confidence: 99%

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Urethral Stricture Disease Guideline Amendment (2023)

Wessells

Morey

Vanni³

et al. 2023

Journal of Urology

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Purpose:The symptoms of urethral stricture are non-specific and may overlap with other common conditions that can confound diagnosis. Urologists play a key role in the initial evaluation of urethral stricture, currently provide all accepted treatments, and must be familiar with the evaluation, diagnostic tests, and surgical treatments for urethral stricture.Materials and Methods:A systematic review of the literature using the Pubmed, Embase, and Cochrane databases (search dates January 1, 1990 to January 12, 2015) was conducted to identify peer-reviewed publications relevant to the diagnosis and treatment of urethral stricture in men. The review yielded an evidence base of 250 articles after application of inclusion/exclusion criteria. The search for the 2023 Amendment was modified to included females and males (search dates December 2015—October 2022 for males; January 1990—October 2022 for females) and a new Key Question on sexual dysfunction was added (search dates: January 1990—10/2022). After inclusion and exclusion criteria were applied, 81 studies were added to the existing evidence base.Results:Once a urethral stricture is diagnosed, clinicians should determine the length and location of the stricture in order to inform treatment. After a period of urethral rest, patients with short (<2cm) bulbar urethral stricture may be treated endoscopically. Urethroplasty may be performed by an experienced surgeon in patients with first time or recurrent anterior and posterior urethral strictures. The best treatment option for urethral stricture in female patients is urethroplasty using oral mucosa grafts or vaginal flaps rather than endoscopic treatment.Conclusion:This guideline provides evidence-based guidance to clinicians and patients regarding how to recognize symptoms and signs of a urethral stricture/stenosis, carry out appropriate testing to determine the location and severity of the stricture, and recommend the best options for treatment. The most effective approach for a particular patient is best determined by the individual clinician and patient in the context of that patient's history, values, and goals for treatment.

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Section: Guideline Statementsmentioning

confidence: 99%

Section: Guideline Statementsmentioning

confidence: 99%

Section: Guideline Statementsmentioning

confidence: 99%

See 1 more Smart Citation

Urethral Stricture Disease Guideline Amendment (2023)

Wessells

Morey

Vanni³

et al. 2023

Journal of Urology

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“…However, it is advised to reserve this for short strictures (<0.5cm) only. 17,23,[61][62][63]70,[88][89][90][91][92][93] The majority of robotic reports are transperitoneal, but Lavolle et al 94 and Diamant et al 64 also trialed extraperitoneal access with end-to-end anastomosis. However, outcomes were worse when compared to the transperitoneal approach and first-time treatment success was only 50% and continence rates ranged from 37.5% to 50%.…”

Section: Access To Defectmentioning

confidence: 99%

“…Opening of the bladder neck can then be done with the aid of endoscopic visualisation. 19,22,24,63,67,68,91,95,96 A modified perineal approach has been recently described by Pinto et al 69 and is referred to as the Anterior Sagittal Transrectal Approach (ASTRA). The authors described a technique where the patient is placed in a Jackknife position.…”

Section: Access To Defectmentioning

confidence: 99%

Refractory Bladder Neck Contracture (BNC) After Radical Prostatectomy: Prevalence, Impact and Management Challenges

Uguzova,

Beisland,

Honoré

et al. 2023

RRU

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Bladder neck contracture is a recognised complication associated with radical prostatectomy. The management can be challenging, especially when refractory to initial intervention strategies. For the patient, the burden of disease is high and continence status cannot be overlooked. This review serves to provide an overview of the management of this recognised clinical pathology. Consideration needs to be given to minimally invasive approaches such as endoscopic incision, injectables, implantable devices as well as major reconstructive surgery where the condition persists. For the latter, this can involve open and robotic surgery as well as use of grafts and artificial sphincter surgery. These elements underline the need for a tailored and a patient centred approach.

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WITHDRAWN: Prerectal-transperineal approach for treatment of recurrent vesico-urethral anastomotic stenosis after radical prostatectomy

Cited by 2 publications

References 20 publications

Urethral Stricture Disease Guideline Amendment (2023)

Urethral Stricture Disease Guideline Amendment (2023)

Refractory Bladder Neck Contracture (BNC) After Radical Prostatectomy: Prevalence, Impact and Management Challenges

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