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- W4386574809 abstract "Vesicourethral anastomotic stenosis and bladder neck contracture may result from treatment of benign and malignant prostate conditions. Typically, attempts are made to incise these areas of scar tissue – unfortunately, patency is often temporary and recurrence is common. Patients with particularly stubborn stenosis will find themselves at the doorstep of the reconstructive urologist. Open repair, though more definitive than endoscopic management, is fraught with challenges: the bladder neck is difficult to access from both above and below, and even if a repair is successful, the patient will often be left incontinent. In this manuscript, Zhang et al describe a series of over 100 men with posterior urethral stenosis who underwent robotic assisted repair at their institution. The population is diverse in terms of pathology, with a third of patients having prostate radiation alone, a quarter with prostatectomy and radiation, and the remainder with stenosis secondary to prostatectomy, TURP, or trauma. Multiple approaches – excision and primary anastomosis, YV-plasty, buccal mucosal graft urethroplasty, and resiting of the bladder neck – are described, all performed by a single surgeon. The overall success rate, defined as not needing an additional procedure, is quoted at 75%. Forty-one patients required combined robotic transabdominal and perineal approaches – all but one of these patients had a history of radiation plus or minus surgery for prostate cancer. High grade complications were rare and occurred more commonly in previously radiated patients. Not surprisingly, incontinence requiring artificial urinary sphincter was most common in those with history of prostatectomy and radiation (28% of total group)." @default.
- W4386574809 created "2023-09-10" @default.
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- W4386574809 date "2023-09-01" @default.
- W4386574809 modified "2023-09-28" @default.
- W4386574809 title "Robotic-assisted Posterior Urethroplasty: Outcomes From 105 Men in a Single-center Experience – Editorial Commentary" @default.
- W4386574809 doi "https://doi.org/10.1016/j.urology.2023.05.063" @default.
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