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Review
. 2017 Apr 11;9(5):99-110.
doi: 10.1177/1756287217701391. eCollection 2017 Oct.

An update on best practice in the diagnosis and management of post-prostatectomy anastomotic strictures

Nicholas R Rocco  1 , Jack M Zuckerman  2
Affiliations
Review

An update on best practice in the diagnosis and management of post-prostatectomy anastomotic strictures

Nicholas R Rocco et al. Ther Adv Urol. .

Abstract

Postprostatectomy vesicourethral anastomotic stenosis (VUAS) remains a challenging problem for both patient and urologist. Improved surgical techniques and perioperative identification and treatment of risk factors has led to a decline over the last several decades. High-level evidence to guide management is lacking, primarily relying on small retrospective studies and expert opinion. Endourologic therapies, including dilation and transurethral incision or resection with or without adjunct injection of scar modulators is considered first-line management. Recalcitrant VUAS requires surgical reconstruction of the vesicourethral anastomosis, and in poor surgical candidates, a chronic indwelling catheter or urinary diversion may be the only option. This review provides an update in the diagnosis and management of postprostatectomy VUAS.

Keywords: bladder neck contracture; prostate cancer; radical prostatectomy; urethral stricture; urinary incontinence; vesicourethral anastomotic stenosis.

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Conflict of interest statement

Conflict of interest statement: The authors declare that there is no conflict of interest.

Figures

Figure 1.
Figure 1.
Complete urethral mobilization.
Figure 2.
Figure 2.
Urethra trascected, corpora split and dorsal venous complex (DVC) ligated, exposing the inferior pubis.
Figure 3.
Figure 3.
Completed anastomosis with spongiosum lying in groove between corporal bodies.
See this image and copyright information in PMC

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