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World Journal of Urology

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01-10-2014 | Original Article

Transperineal reanastomosis for the treatment for highly recurrent anastomotic strictures as a last option before urinary diversion

Authors: Christoph Philip Reiss, Daniel Pfalzgraf, Luis Alex Kluth, Armin Soave, Margit Fisch, Roland Dahlem

Published in: World Journal of Urology | Issue 5/2014

Abstract

Purpose

To evaluate safety and efficacy of open transperineal reanastomosis (TPRA) for highly recurrent anastomotic strictures (AS) after radical prostatectomy. While the majority of AS can be managed successfully by endoscopic treatment, in highly recurrent AS, open reanastomosis represents a viable therapeutic option.

Methods

Retrospective analysis by standardized questionnaire, inquiring for recurrence, incontinence, sexual function, satisfaction and changes in quality of life (QoL) in 15 patients undergoing TPRA 08/2007–03/2010.

Results

Mean patient age was 65 years (51–75) and mean follow-up 20.5 months (5.8–37.0). Success rate was 93.3 % (14/15). The single recurrence was successfully treated by cold knife incision. Incontinence was found in 93.3 % (14/15) preoperatively and aggravated in 60 % (9/15) after surgery; no de novo incontinence occurred. Implantation of an artificial urinary sphincter (AUS) has been performed successfully in 10 patients, 2 refused implantation and 2 are scheduled for surgery. Erectile dysfunction was present in 86.7 % (13/15); 13.3 % (2/15) reported a severely declined rigidity. Compared to preoperative status, 33.3 % (5/15) complained about impaired erectile function after TPRA. A good or very good subjective overall health status and an improvement in QoL were noted in 86.7 % (13/15). Patient satisfaction with the outcome of TPRA was high or very high in 13; two were undecided.

Conclusions

After repeated endoscopic treatment, TPRA is a valuable therapeutic option in selected patients with an overall success rate of 93.3 % (14/15) for anastomotic patency, which can even be raised to 100 % by further transurethral surgery. Incontinence can be easily treated by implantation of an AUS.

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Title: Transperineal reanastomosis for the treatment for highly recurrent anastomotic strictures as a last option before urinary diversion
Authors: Christoph Philip Reiss
Daniel Pfalzgraf
Luis Alex Kluth
Armin Soave
Margit Fisch
Roland Dahlem
Publication date: 01-10-2014
Publisher: Springer Berlin Heidelberg
Published in: World Journal of Urology / Issue 5/2014
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-013-1180-6

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Transperineal reanastomosis for the treatment for highly recurrent anastomotic strictures as a last option before urinary diversion

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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