Robotic Y-V Plasty for Recalcitrant Bladder Neck Contracture

Granieri, Michael A.; Weinberg, Aaron; Sun, Jeffrey; Stifelman, Michael; Zhao, Lee C.

doi:10.1016/j.urology.2018.04.017

Cited by 55 publications

(27 citation statements)

References 4 publications

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“…Recently, the usefulness and effectiveness of robotic Y-V plasty of the bladder neck have been reported. 23 However, robotic reconstruction is not possible, because it is not covered by insurance in Japan. Another procedure (i.e.…”

Section: Discussionmentioning

confidence: 99%

Deep lateral transurethral incision for vesicourethral anastomotic stenosis after radical prostatectomy

et al. 2021

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Abbreviations & Acronyms AUS = artificial urinary sphincter BCR = biochemical recurrence BMI = body mass index DLI = deep lateral incision DM = diabetes mellitus IHD = ischemic heart disease IQR = interquartile range LRP = laparoscopic radical prostatectomy RARP = robot-assisted radical prostatectomy RP = radical prostatectomy RRP = retropubic radical prostatectomy SPT = suprapubic tube UI = urinary incontinence VUAS = vesicourethral anastomotic stenosis

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Section: Discussionmentioning

confidence: 99%

Deep lateral transurethral incision for vesicourethral anastomotic stenosis after radical prostatectomy

et al. 2021

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“…For reconstruction, although there are abdominoperineal, perineal, and transpubic approaches, 27 , 28 recently the Y–V Plasty procedure, which can be performed with robot-assisted laparoscopy, was demonstrated and promising results have been published. 29 , 30 Clinical outcomes in all these treatment modalities report very variable success or recurrence rates. In the present cohort all patients had been treated before, more than once, with minimally invasive treatment modalities.…”

Section: Discussionmentioning

confidence: 99%

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

Teke

Bosnalı

Kara

et al. 2021

Prostate International

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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.

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“…The use of robotic approach to bladder neck reconstruction is promising, with a 75-100% success rate with minimal incontinence. [16][17][18]…”

Section: Discussionmentioning

confidence: 99%

Triamcinolone acetonide injections for the treatment of recalcitrant post-radical prostatectomy vesicourethral anastomotic stenosis: A retrospective look at efficacy and safety

Neu¹,

Vigil²,

Locke³

et al. 2020

CUAJ

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Introduction: We aimed to evaluate the success of bladder neck injections of triamcinolone at the time of transurethral bladder neck incision (BNI) for prevention of recurrent vesicourethral anastomotic stenosis (VUAS) following prostate cancer treatment. Methods: This is a retrospective cohort study examining patients with recurrent VUAS post-RP ± radiation treated with triamcinolone injections at the time of BNI. VUAS was diagnosed by symptoms followed by cystoscopy or urethrography. The outpatient procedures were done under general anesthesia. Cold knife incisions were made at the three, nine, and 12 o’clock BN positions, followed by triamcinolone injections (4 mg/mL) into the three and nine o’clock incision sites. Treatment outcomes were determined with cystoscopy. Results: Eighteen men underwent 25 procedures over a four-year period. Median age at diagnosis of VUAS was 65 (interquartile range [IQR] 61–68); median time to VUAS from RP was eight months (IQR 5–12). Fourteen patients (78%) had radiation treatment. The cohort had 128 unsuccessful VUAS treatments, with a median of five failed treatments per patient (IQR 3–10). Failed treatments included BN dilation, BNI, BN injection of mitomycin C, and urethral stent placement. Success rate after a mean of 16.3 months (standard deviation [SD] 8.1) from the time of triamcinolone injection was 83% (15/18). Six patients went on to have successful incontinence surgery. Five patients (28%) had treatment complications (bleeding, urinary tract infection, pain, and urinary extravasation). The three non-responders are stable and awaiting re-treatment with triamcinolone injection. Conclusions: Triamcinolone bladder neck injections for post-RP VUAS are a useful and safe treatment for recurrent stenosis.

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Robotic Y-V Plasty for Recalcitrant Bladder Neck Contracture

Cited by 55 publications

References 4 publications

Deep lateral transurethral incision for vesicourethral anastomotic stenosis after radical prostatectomy

Deep lateral transurethral incision for vesicourethral anastomotic stenosis after radical prostatectomy

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

Triamcinolone acetonide injections for the treatment of recalcitrant post-radical prostatectomy vesicourethral anastomotic stenosis: A retrospective look at efficacy and safety

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