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- W4310357335 abstract "To describe step by step a new endo-laparoscopic technique for recalcitrant contractures of the bladder neck after radical prostatectomy. Due to the combination of endoscopy (urethra) and laparoscopy (bladder) maximal exposure is obtained on the bladder neck stenosis. After resecting all scar tissue endoscopically, a harvested buccal graft is inserted and placed over the resected area. Subsequently quilting is performed. We treated two patients with this new technique. The first patient had a radical prostatectomy in his medical history. The second patient had a pelvic fracture with rupture of the posterior urethra. He also underwent a transurethral resection of the prostate (TURP) and radiotherapy for prostate cancer. Both procedures were performed in 90 minutes after which a urinary catheter was left in place for 4 weeks. When comparing the pre- and postoperative uroflowmetry and cystography of patient 1 after 4 weeks, significant differences were seen. The uroflow improved from a Qmax of 1ml/s to 14ml/s and the post-operative cystography revealed good patency of bladder neck and proximal urethra. Similar results were reported after 2 years of follow-up. Patient 2 had no postoperative complications and his cystoscopy at three months showed a patent proximal urethra. However, at that moment pure stress incontinence was reported as expected and therefore scheduled for an artificial urinary sphincter (AUS). Based on these two cases, we can state that this new endo-laparoscopic technique is a valuable treatment option in complex vesico-urethral anastomosis stenosis (VUAS) cases. It is technically less demanding than conventional major surgical procedures and has a more favorable risk profile. It can be situated as an intermediary step between existing first line endoscopic approaches and more complex (eg. reanostomosis with perineal dissection) or incapacitating (eg. urinary diversions) interventions." @default.
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- W4310357335 date "2023-03-01" @default.
- W4310357335 modified "2023-10-01" @default.
- W4310357335 title "Buccal mucosa endo-laparoscopic repair of bladder neck stenosis after radical prostatectomy" @default.
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- W4310357335 doi "https://doi.org/10.1016/j.urolvj.2022.100192" @default.
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