Urethroplasty for Radiotherapy Induced Bulbomembranous Strictures: A Multi-Institutional Experience

Meeks, Joshua J.; Brandes, Steven B.; Morey, Allen F.; Thom, Matthew; Mehdiratta, Nitin; Valadez, Celeste; Granieri, Michael A.; Gonzalez, Christopher

doi:10.1016/j.juro.2010.12.038

Cited by 56 publications

(41 citation statements)

References 17 publications

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“…In the minority of patients (3/30) this was a transient phenomenon, but in 12/30 (40%) of patients this incontinence was long lasting. In the end 4/30 (13%) patients finally required an artificial urinary sphincter implant to restore continence (Meeks et al, 2011). This is in accordance with sporadic clinical experience of severe incontinence after complex urological history.…”

Section: Urinary Incontinencesupporting

confidence: 81%

The Use of Buccal Mucosa in Bulbar Stricture Repair: Morbidity and Functional Outcome

Aa¹,

Eeckt²,

Joniau³

2011

Current Concepts of Urethroplasty

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Section: Urinary Incontinencesupporting

confidence: 81%

The Use of Buccal Mucosa in Bulbar Stricture Repair: Morbidity and Functional Outcome

Aa¹,

Eeckt²,

Joniau³

2011

Current Concepts of Urethroplasty

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“…BMG with or without gracilis muscle flap was done in 70 patients and had a success rate of 71–80% within 2–4 years (70,73,74,76). Flap urethroplasty was performed in 10 patients and had a success rate that varied between 50–100% within 2–4 years (70,71,76). Patient should be counseled that new onset urinary incontinence is seen in 5–35% after surgery and may require further intervention.…”

Section: Managementmentioning

confidence: 99%

Management of bladder neck stenosis and urethral stricture and stenosis following treatment for prostate cancer

Nicholson

Al-Hakeem

Maldonado

et al. 2017

Transl. Androl. Urol.

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The aim of this review is to examine all urethral strictures and stenoses subsequent to treatment for prostate cancer, including radical prostatectomy (RP), radiotherapy, high intensity focused ultrasound (HIFU) and cryotherapy. The overall majority respond to endoscopic treatment, including dilatation, direct visual internal urethrotomy (DVIU) or bladder neck incision (BNI). There are adjunct treatments to endoscopic management, including injections of corticosteroids and mitomycin C (MMC) and urethral stents, which remain controversial and are not currently mainstay of treatment. Recalcitrant strictures are most commonly managed with urethroplasty, while recalcitrant stenosis is relatively rare yet almost always associated with bothersome urinary incontinence, requiring bladder neck reconstruction and subsequent artificial urinary sphincter (AUS) implantation, or urinary diversion for the devastated outlet.

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“…Half of the patients became incontinent and 4 went on to receive artificial urinary sphincters. 36 Kollmeier and colleagues reported their results of performing transurethral resections (TURPs) on 38 post-BT patients presenting with urinary retention; 18% were initially incontinent, and this number increased to 36% after 2 years post TURP. 37 Among patients presenting with urinary fistulas post-RT, one study reports their management consisting of initial fecal diversion by colostomy or ileostomy in 81% of cases with a trial of bladder drainage by Foley catheter; unfortunately, 82% of these patients had to undergo subsequent cystectomy and urinary diversion.…”

Section: Management Of Radiation-induced Complicationsmentioning

confidence: 99%

Management of post-radiation therapy complications among prostate cancer patients: A case series

Flannigan

Baverstock

2014

CUAJ

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Introduction: Treating prostate cancer with radiation therapy (RT) is a viable option, albeit with its own profile of complications. We describe a unique Canadian report of a single surgeon (RJB) experience in the management of complex post-prostate cancer RT complications. Methods: We retrospectively analyzed patients who had previously received external beam radiation (XRT) or brachytherapy (BT) for prostate cancer referred to a single surgeon for persistent urologic related difficulties between 2005 and 2010. We used the Radiation Therapy Oncology Group (RTOG) morbidity grading system to assign each patient a 1 to 5 grade for their greatest complication. Results: In total, 15 patients were identified with a total of 43 RT-related complications. Of these 43 complications, 19 presented with obstruction, 8 with radiation failure or new bladder cancer, 6 with hematuria, 5 with intractable incontinence, and 5 with urinary tract infections. These patients required several investigations prior to treatment. Treatment of these complications used surgical, local and medical approaches. In the end, 1 patient had total incontinence, 3 improved their incontinence, 3 had self-catheterization and dilation, 1 voided well, 3 underwent cystectomy with ileo-conduits, 2 had chronic hematuria, and 2 passed away. Conclusion: These patients are heavily investigated and require significant resources, including patient visits, diagnostics and treatment modalities to optimize their condition. Cure is not always possible, but the aim to improve quality of life should guide management.

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Urethroplasty for Radiotherapy Induced Bulbomembranous Strictures: A Multi-Institutional Experience

Abstract: Urethroplasty for radiation induced strictures has an acceptable rate of success and can be performed without tissue transfer techniques in most cases. Almost half of men will experience some degree of incontinence as a result of surgery but erectile function appears to be preserved.

Cited by 56 publications

References 17 publications

The Use of Buccal Mucosa in Bulbar Stricture Repair: Morbidity and Functional Outcome

The Use of Buccal Mucosa in Bulbar Stricture Repair: Morbidity and Functional Outcome

Management of bladder neck stenosis and urethral stricture and stenosis following treatment for prostate cancer

Management of post-radiation therapy complications among prostate cancer patients: A case series

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