Minimal invasive management of bladder neck contracture using Allium round posterior stent: the long-term results

Abstract

Background The purpose of this study was to assess the long-term clinical efficacy of temporary, Allium round posterior stent (RPS) used for treatment of recurrent bladder neck contracture (BNC). Methods Records of 42 patients with recurrent BNC who underwent Allium RPS placement after bladder neck incision, between 2009 and 2019, were analyzed. After stent removal, the success criteria for Allium RPS treatment were defined as: no evidence of stricture on urethrogram or endoscopy; more than 12 ml/sec of urinary peak flow; and no recurrent urinary tract infections. Based on clinical success, patients were divided into two groups and compared. Clinical success was evaluated with particular regard to stent indwelling time and contracture etiology. Results The mean ± standard deviation age, stricture length, and indwelling time were 66.7 ± 9 years, 2.4 ± 1.4 cm, and 7.7 ± 2.2 months, respectively. Median (range) follow-up was 59 (8–73) months. The etiologies of BNC in this cohort were 57.1% retropubic radical prostatectomy; and 42.9% transurethral resection of prostate. Overall clinical success was achieved in 64.3% and the success rates did not differ by etiology. The success rates were 54.2% and 77.8% ( P = 0.118) for retropubic radical prostatectomy and transurethral resection of prostate, respectively. Longer indwelling time (8–14 vs 3–7, months) was significantly associated with clinical success (78.3% vs 47.4%, P = 0.040). Conclusion Our data suggest that better clinical success was associated with longer indwelling time for stent in BNC treatment. In BNC management, Allium RPS treatment may be considered since its clinical efficacy is acceptable and tolerable.

Robotic-assisted simple prostatectomy after prostatic arterial embolization for large benign prostate hyperplasia: Initial experience

“…The effectiveness of PAE in controlling massive blood loss following biopsy, prostatectomy, or TURP has been reported. 17 , 18 , 19 Despite large BPH, our study showed a high success rate of RASP after PAE with minimal blood loss. PAE did not induce adhesive changes in the prostate, which make surgery unmanageable.…”

Post‐prostatectomy anastomotic stenosis: systematic review and meta‐analysis of endoscopic treatment

“…The risk of bias assessment was unfavourable for a large majority of studies regarding the measurement of the condition (utilisation of valid method, measurement in a standard, reliable way; Fig. 3 [1,19,27–64]).…”

Do bony pelvis parameters affect perioperative outcomes in open radical prostatectomy?

“…The vesicourethral anastomosis in RP surgery is one of the most critical and challenging parts in terms of affecting the patient's quality of life after the surgery. 16 Failure to achieve a watertight anastomosis is associated with postoperative urine leakage, VUAS, and delayed urinary continence. 17 We can base on the lack of a significant relationship between the pelvic measurements and VUAS and urine leakage to the fact that all surgeries were performed by a surgeon with experience in this field, and the anastomosis technique made from six foci was used as a standard in the surgery.…”