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Current Urology Reports
Published in: Current Urology Reports 10/2017

01-10-2017 | Benign Prostatic Hyperplasia (K McVary, Section Editor)

Bladder Neck Contracture After Endoscopic Surgery for Benign Prostatic Obstruction: Incidence, Treatment, and Outcomes

Authors: Giulia Primiceri, Pietro Castellan, Michele Marchioni, Luigi Schips, Luca Cindolo

Published in: Current Urology Reports | Issue 10/2017

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Abstract

Purpose of Review

In recent years, new endoscopic techniques have been developed to reduce the morbidity of transurethral resection of the prostate. Nonetheless, complications are still frequently encountered and bladder neck contracture (BNC) is a well-described complication after endoscopic surgery for benign prostatic obstruction (BPO). Our aim is to review and discuss the contemporary incidence, the relevant treatment strategies, and their outcomes.

Recent Findings

Findings suggest that BNC is a common complication with an acceptably low incidence but can range in complexity. Most contractures were usually managed successfully with conservative measures; nevertheless, in patients with refractory BNC, various valuable management strategies were employed with different kinds of success and re-treatment rates.

Summary

In consideration of these challenging possibilities, the treatment of BNC requires a tailored approach with patient-specific management that can range from simple procedures to complex surgical reconstruction.
Literature
1.
Cornu JN, Ahyai S, Bachmann A, et al. A systematic review and meta-analysis of functional outcomes and complications following transurethral procedures for lower urinary tract symptoms resulting from benign prostatic obstruction: an update. Eur Urol. 2015;67:1066–96.CrossRefPubMed
2.
Gratzke C, Bachmann A, Descazeaud A, et al. EAU guidelines on the assessment of non-neurogenic male lower urinary tract symptoms including benign prostatic obstruction. Eur Urol. 2015;67:1099–109.CrossRefPubMed
3.
Tao H, Jiang YY, Jun Q, et al. Analysis of risk factors leading to postoperative urethral stricture and bladder neck contracture following transurethral resection of prostate. Int Braz J Urol. 2016;42:302–11.CrossRefPubMedPubMedCentral
4.
Lin Y, Wu X, Xu A, et al. Transurethral enucleation of the prostate versus transvesical open prostatectomy for large benign prostatic hyperplasia: a systematic review and meta-analysis of randomized controlled trials. World J Urol. 2016;34:1207–19.CrossRefPubMed
5.
Cindolo L, Marchioni M, Emiliani E, et al. Bladder neck contracture after surgery for benign prostatic obstruction. Minerva urologica e nefrologica = The Italian journal of urology and nephrology. 2017;69:133–43.PubMed
6.
Madersbacher S, Marberger M. Is transurethral resection of the prostate still justified. BJU Int. 1999;83:227–37.CrossRefPubMed
7.
Ahyai SA, Gilling P, Kaplan SA, et al. Meta-analysis of functional outcomes and complications following transurethral procedures for lower urinary tract symptoms resulting from benign prostatic enlargement. Eur Urol. 2010;58:384–97.CrossRefPubMed
8.
Al-Rawashdah SF, Pastore AL, Salhi YA, et al. Prospective randomized study comparing monopolar with bipolar transurethral resection of prostate in benign prostatic obstruction: 36-month outcomes. World J Urol. 2017; doi:10.​1007/​s00345-017-2023-7.
9.
Mamoulakis C, Skolarikos A, Schulze M, et al. Results from an international multicentre double-blind randomized controlled trial on the perioperative efficacy and safety of bipolar vs monopolar transurethral resection of the prostate. BJU Int. 2012;109:240–8.CrossRefPubMed
10.
Tang Y, Li J, Pu C, et al. Bipolar transurethral resection versus monopolar transurethral resection for benign prostatic hypertrophy: a systematic review and meta-analysis. J Endourol. 2014;28:1107–14.CrossRefPubMedPubMedCentral
11.
Herrmann TR, Liatsikos EN, Nagele U, et al. EAU guidelines on laser technologies. Eur Urol. 2012;61:783–95.CrossRefPubMed
12.
Petros S. The evolution of ktp laser vaporization of prostate. Yonsei Med J. 2008;49(2):189–99.CrossRef
13.
Castellan P, Castellucci R, Schips L, et al. Safety, efficacy and reliability of 180-W GreenLight laser technology for prostate vaporization: review of the literature. World J Urol. 2015;33:599–607.CrossRefPubMed
14.
Kang DH, Cho KS, Ham WS, et al. A systematic review and meta-analysis of functional outcomes and complications following the photoselective vaporization of the prostate and monopolar transurethral resection of the prostate. World J Mens Health. 2016;34:110–22.CrossRefPubMedPubMedCentral
15.
Barbalat Y, Velez MC, Sayegh CI, et al. Evidence of the efficacy and safety of the thulium laser in the treatment of men with benign prostatic obstruction. Ther Adv Urol. 2016;8:181–91.CrossRefPubMedPubMedCentral
16.
Elkoushy MA, Elshal AM, Elhilali MM. Reoperation after holmium laser enucleation of the prostate for management of benign prostatic hyperplasia: assessment of risk factors with time to event analysis. J Endourol. 2015;29:797–804.CrossRefPubMed
17.
Krambeck AE, Handa SE, Lingeman JE. Experience with more than 1,000 holmium laser prostate enucleations for benign prostatic hyperplasia. J Urol. 2013;189:S141–5.CrossRefPubMed
18.
Elshal AM, Elmansy HM, Elhilali MM. Two laser ablation techniques for a prostate less than 60 mL: lessons learned 70 months after a randomized controlled trial. Urology. 2013;82:416–22.CrossRefPubMed
19.
• Reiss CP, Rosenbaum CM, Becker A, et al. The T-plasty: a modified YV-plasty for highly recurrent bladder neck contracture after transurethral surgery for benign hyperplasia of the prostate: clinical outcome and patient satisfaction. World J Urol. 2016;34:1437–42. Description of the technique of T-plasty as a valuable treatment option for highly recurrent BNC compared to other more invasive techniques CrossRefPubMed
20.
•• Parker DC, Simhan J. Management of complications after surgical outlet reduction for benign prostatic obstruction. Can J Urol. 2015;22(Suppl 1):88–92. A review where were examinated in-depth the contemporary treatment strategies for long term complications of surgical outlet reduction procedures PubMed
21.
Ramirez D, Simhan J, Hudak SJ, et al. Standardized approach for the treatment of refractory bladder neck contractures. Urol Clin North Am. 2013;40:371–80.CrossRefPubMed
22.
Eltahawy E, Gur U, Virasoro R, et al. Management of recurrent anastomotic stenosis following radical prostatectomy using holmium laser and steroid injection. BJU Int. 2008;102:796–8.CrossRefPubMed
23.
Redshaw JD, Broghammer JA, Smith TG 3rd, et al. Intralesional injection of mitomycin C at transurethral incision of bladder neck contracture may offer limited benefit: TURNS study group. J Urol. 2015;193:587–92.CrossRefPubMed
24.
Young BW. The retropubic approach to vesical neck obstruction in children. Surg Gynecol Obstet. 1953;96:150–4.PubMed
25.
• Kaynar M, Gul M, Kucur M, et al. Necessity of routine histopathological evaluation subsequent to bladder neck contracture resection. Cent European J Urol. 2016;69:353–7. This document indicated that in the absence of previous risk factors (T3 or T4 stage PCa or bladder tumor), routine histological evaluation of bladder neck specimens is not necessary. PubMedPubMedCentral
26.
Herschorn S, Elliott S, Coburn M, et al. SIU/ICUD consultation on urethral strictures: posterior urethral stenosis after treatment of prostate cancer. Urology. 2014;83:S59–70.CrossRefPubMed
27.
Altay B, Erkurt B, Kiremit MC, et al. 180-W XPS GreenLight laser vaporization for benign prostate hyperplasia: 12-month safety and efficacy results for glands larger than 80 mL. Lasers Med Sci. 2015;30:317–23.CrossRefPubMed
28.
Guo S, Muller G, Lehmann K, et al. The 80-W KTP GreenLight laser vaporization of the prostate versus transurethral resection of the prostate (TURP): adjusted analysis of 5-year results of a prospective non-randomized bi-left study. Lasers Med Sci. 2015;30:1147–51.CrossRefPubMed
29.
Thomas JA, Tubaro A, Barber N, et al. A multileft randomized noninferiority trial comparing GreenLight-XPS laser vaporization of the prostate and transurethral resection of the prostate for the treatment of benign prostatic obstruction: two-yr outcomes of the GOLIATH study. Eur Urol. 2016;69:94–102.CrossRefPubMed
30.
Netsch C, Bach T, Pohlmann L, et al. Comparison of 120–200 W 2 μm thulium:yttrium-aluminum-garnet vapoenucleation of the prostate. J Endourol. 2012;26:224–9.CrossRefPubMed
31.
Netsch C, Pohlmann L, Herrmann TR, et al. 120-W 2-μm thulium:yttrium-aluminium-garnet vapoenucleation of the prostate: 12-month follow-up. BJU Int. 2012;110:96–101.CrossRefPubMed
Metadata
Title
Bladder Neck Contracture After Endoscopic Surgery for Benign Prostatic Obstruction: Incidence, Treatment, and Outcomes
Authors
Giulia Primiceri
Pietro Castellan
Michele Marchioni
Luigi Schips
Luca Cindolo
Publication date
01-10-2017
Publisher
Springer US
Published in
Current Urology Reports / Issue 10/2017
Print ISSN: 1527-2737
Electronic ISSN: 1534-6285
DOI
https://doi.org/10.1007/s11934-017-0723-6

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