Assessment of the Balloon Dilation Efficiency in Bladder Neck Contracture after Transurethral Interventions on the Prostate

Abstract

Purpose: The aim was to assess the results of balloon dilation in patients with bladder neck contracture (BNC) after endoscopic surgery for benign prostatic hyperplasia (BPH). Materials and Methods: The study involved 120 patients with recurrent BNC after transurethral interventions for BPH. All patients underwent transurethral resection (TUR) of the bladder neck and were divided into two groups: Group A (n = 45) included men who, after TUR, additionally underwent repeated balloon dilation, whereas the control group B (n = 75) included men who were treated with alpha-blockers alone. Results: In 9 months after TUR and 3 months after the 4th balloon dilation procedure in Group A, the mean international prostate symptom score (IPSS) decreased from 20.1 ± 8.4 to 17.2 ± 7.4, and the IPSS-quality of life was 4.2 ± 1.2 (P > 0.05). In Group B, they were 21.7 ± 7.7 and 4.7 ± 1.1 (P > 0.05), respectively. In addition, the mean flow rate in Group A was 13.2 ± 5.4 ml/s, whereas in Group B, it was 8.7 ± 4.9 ml/s (P < 0.05). There was a significant decrease in the postvoid residual urine volume from 76.2 ± 96.1 ml to 37.6 ± 55.1 ml in Group A, whereas, in Group B, it increased from 63.0 ± 36.9 ml to 79.4 ± 71.6 ml (P > 0.05). Furthermore, 28.0% of patients of Group B and 13.3% of patients of Group A underwent repeated TUR of the bladder neck in 9 months follow-up period (P < 0.05). Conclusion: Balloon dilation is a safe less invasive procedure and can reduce the possibility of BNC recurrence and thus the rate of repeated transurethral interventions.

Ultrasound-Triggerable Coatings for Foley Catheter Balloons for Local Release of Anti-Inflammatory Drugs during Bladder Neck Dilation

“…At the first stage of the study, the 5(6)-carboxyfluorescein was used solely for the initial proof of concept for the controlled cargo release from microchambers under exposure to ultrasound in the diagnostic range as used in the clinic. In this regard, the ultrasound settings and exposure time (10 min [ 5 ]) were chosen according to the clinical procedure (balloon dilation). This allowed us to make no changes in the manipulation protocol.…”

“…Note that our therapeutic concept does not require additional manipulations from clinicians. The trigger for the opening of the microchambers is ultrasonic exposure, which is used during manipulation to position and guide the dilation process anyway [ 5 ].…”

“…Transurethral resection is currently the main treatment option for BNC, but the recurrence rate after this procedure can reach up to 38% [ 4 ]. At the same time, balloon dilation [ 4 , 5 ] and self-dilation [ 6 ] can be promising and minimally invasive alternatives for the treatment of recurrent BNC [ 4 , 7 , 8 , 9 ]. However, this option is viable only for well-motivated patients because the treatment involves several procedures with an individually selected frequency and requires a great deal of tolerance and compliance [ 1 ].…”