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Published in: Journal of Medical Case Reports 1/2012

Open Access 01-12-2012 | Case report

Recurrent urethrovesical anastomotic strictures following artificial urinary sphincter implantation: a case report

Authors: Ioannis Adamakis, Stavros I Tyritzis, Ioanna Vasileiou, Ioannis Katafigiotis, Ioannis Leotsakos, Sotiria Fergadaki, Konstantinos G Stravodimos, Constantinos A Constantinides

Published in: Journal of Medical Case Reports | Issue 1/2012

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Abstract

Introduction

The management of an anastomotic stricture after a radical prostatectomy can become a complex and difficult situation when an artificial urinary sphincter precedes the formation of the stricture. The urethral narrowing does not allow the passage of the routinely used urological instruments and no previous reports have suggested alternate approaches.

Case presentation

We present the case of a 68-year-old Greek man diagnosed as having a recurrent anastomotic stricture approximately two years after a radical prostatectomy and three years after the implantation of an artificial urinary sphincter, and propose novel alternate methods of treatment. Our patient was first subjected to stricture incision with the use of a rigid ureteroscope with a holmium:yttrium-aluminium-garnet laser fiber, which was followed by a second successful attempt with the use of a pediatric resectoscope. After a one-year follow-up, our patient is doing well, with no evidence of recurrence.

Conclusions

To the best of our knowledge, this is the first report of the management of recurrent urethral strictures following an artificial urinary sphincter implantation. Minimal invasive techniques with the use of small caliber instruments may offer efficient treatment options, diminishing the danger of urethral corrosion.
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Literature
1.
go back to reference Besarini D, Amoroso P, Kirky R: Bladder neck contracture after radical retropubic prostatectomy. BJU Int. 2004, 94: 1245-1247. 10.1111/j.1464-410X.2004.05151.x.CrossRef Besarini D, Amoroso P, Kirky R: Bladder neck contracture after radical retropubic prostatectomy. BJU Int. 2004, 94: 1245-1247. 10.1111/j.1464-410X.2004.05151.x.CrossRef
2.
go back to reference Augustin H, Pummer K, Daghofer F, Habermann H, Primus G, Hubmer G: Patient self-reporting questionnaire on urological morbidity and bother after radical retropubic prostatectomy. Eur Urol. 2002, 42: 112-117. 10.1016/S0302-2838(02)00259-2.CrossRefPubMed Augustin H, Pummer K, Daghofer F, Habermann H, Primus G, Hubmer G: Patient self-reporting questionnaire on urological morbidity and bother after radical retropubic prostatectomy. Eur Urol. 2002, 42: 112-117. 10.1016/S0302-2838(02)00259-2.CrossRefPubMed
3.
go back to reference Elliot DS, Boone TB: Combined stent and artificial urinary sphincter for management of severe recurrent bladder neck contracture and stress incontinence after prostatectomy: a long-term evaluation. J Urol. 2001, 165: 413-415. 10.1097/00005392-200102000-00014.CrossRef Elliot DS, Boone TB: Combined stent and artificial urinary sphincter for management of severe recurrent bladder neck contracture and stress incontinence after prostatectomy: a long-term evaluation. J Urol. 2001, 165: 413-415. 10.1097/00005392-200102000-00014.CrossRef
4.
go back to reference Eltahawy E, Gur U, Virasoro R, Schlossberg SM, Jordan GH: Management of recurrent anastomotic stenosis following radical prostatectomy using holmium laser and steroid injection. BJU Int. 2008, 102: 796-798. 10.1111/j.1464-410X.2008.07919.x.CrossRefPubMed Eltahawy E, Gur U, Virasoro R, Schlossberg SM, Jordan GH: Management of recurrent anastomotic stenosis following radical prostatectomy using holmium laser and steroid injection. BJU Int. 2008, 102: 796-798. 10.1111/j.1464-410X.2008.07919.x.CrossRefPubMed
5.
go back to reference Anger JT, Raj GV, Delvecchio FC, Webster GD: Anastomotic contracture and incontinence after radical prostatectomy: a graded approach to management. J Urol. 2005, 173: 1143-1146. 10.1097/01.ju.0000155624.48337.a5.CrossRefPubMed Anger JT, Raj GV, Delvecchio FC, Webster GD: Anastomotic contracture and incontinence after radical prostatectomy: a graded approach to management. J Urol. 2005, 173: 1143-1146. 10.1097/01.ju.0000155624.48337.a5.CrossRefPubMed
6.
go back to reference Berlin JW, Ramchandani P, Banner MP, Pollack HM, Nodline CF, Wein AJ: Voiding cystourethrography after radical prostatectomy: Normal findings and correlation between contrast extravastation and anastomotic strictures. Am J Roentgenol. 1994, 162: 87-91.CrossRef Berlin JW, Ramchandani P, Banner MP, Pollack HM, Nodline CF, Wein AJ: Voiding cystourethrography after radical prostatectomy: Normal findings and correlation between contrast extravastation and anastomotic strictures. Am J Roentgenol. 1994, 162: 87-91.CrossRef
7.
go back to reference Surya BV, Provet J, Johanson K-E, Brown J: Anastomotic strictures following radical prostatectomy: risk factors and management. J Urol. 1990, 143: 755-758.PubMed Surya BV, Provet J, Johanson K-E, Brown J: Anastomotic strictures following radical prostatectomy: risk factors and management. J Urol. 1990, 143: 755-758.PubMed
8.
go back to reference Kao TC, Cruess DF, Garner D, Foley J, Seay T, Friedrichs P, Thrasher JB, Mooneyhan RD, McLeod DG, Moul JW: Multicenter patient self-reporting questionnaire on impotence, incontinence and stricture after radical prostatectomy. J Urol. 2000, 163: 858-10.1016/S0022-5347(05)67819-6.CrossRefPubMed Kao TC, Cruess DF, Garner D, Foley J, Seay T, Friedrichs P, Thrasher JB, Mooneyhan RD, McLeod DG, Moul JW: Multicenter patient self-reporting questionnaire on impotence, incontinence and stricture after radical prostatectomy. J Urol. 2000, 163: 858-10.1016/S0022-5347(05)67819-6.CrossRefPubMed
9.
go back to reference Moul J, Mooneyhan RM, Kao TC, McLeod DG, Cruess D: Preoperative and operative factors to predict incontinence, impotence and stricture after radical prostatectomy. Prostate Cancer Prostatic Dis. 1998, 1: 242-10.1038/sj.pcan.4500248.CrossRefPubMed Moul J, Mooneyhan RM, Kao TC, McLeod DG, Cruess D: Preoperative and operative factors to predict incontinence, impotence and stricture after radical prostatectomy. Prostate Cancer Prostatic Dis. 1998, 1: 242-10.1038/sj.pcan.4500248.CrossRefPubMed
10.
go back to reference Gousse AE, Tunuguntla HS, Leboeuf L: Two-stage management of severe postprostatectomy bladder neck contracture associated with stress incontinence. Urology. 2005, 65: 316-319. 10.1016/j.urology.2004.09.014.CrossRefPubMed Gousse AE, Tunuguntla HS, Leboeuf L: Two-stage management of severe postprostatectomy bladder neck contracture associated with stress incontinence. Urology. 2005, 65: 316-319. 10.1016/j.urology.2004.09.014.CrossRefPubMed
11.
go back to reference Simonato A, Gregori A, Lissiani A, Carmignani G: Two-stage transperineal management of posterior urethral strictures or bladder neck contractures associated with urinary incontinence after prostate surgery and endoscopic treatment failures. Eur Urol. 2007, 52: 1499-1504. 10.1016/j.eururo.2007.03.053.CrossRefPubMed Simonato A, Gregori A, Lissiani A, Carmignani G: Two-stage transperineal management of posterior urethral strictures or bladder neck contractures associated with urinary incontinence after prostate surgery and endoscopic treatment failures. Eur Urol. 2007, 52: 1499-1504. 10.1016/j.eururo.2007.03.053.CrossRefPubMed
12.
go back to reference Yurkanin JP, Dalkin BL, Cui H: Evaluation of cold knife urethrotomy for the treatment of anastomotic stricture after radical retropubic prostatectomy. J Urol. 2001, 165: 1545-1548. 10.1016/S0022-5347(05)66345-8.CrossRefPubMed Yurkanin JP, Dalkin BL, Cui H: Evaluation of cold knife urethrotomy for the treatment of anastomotic stricture after radical retropubic prostatectomy. J Urol. 2001, 165: 1545-1548. 10.1016/S0022-5347(05)66345-8.CrossRefPubMed
13.
go back to reference Rachmandani P, Banner MP, Berlin JW, Dannenbaum MS, Wein AJ: Vesicourethral anastomotic strictures after radical prostatectomy: efficacy of transurethral balloon dilation. Radiology. 1994, 193: 345-349.CrossRef Rachmandani P, Banner MP, Berlin JW, Dannenbaum MS, Wein AJ: Vesicourethral anastomotic strictures after radical prostatectomy: efficacy of transurethral balloon dilation. Radiology. 1994, 193: 345-349.CrossRef
14.
go back to reference Corujo M, Baldani GH: Epithelialization of permanent stents. J Endourol. 1997, 11: 477-10.1089/end.1997.11.477.CrossRefPubMed Corujo M, Baldani GH: Epithelialization of permanent stents. J Endourol. 1997, 11: 477-10.1089/end.1997.11.477.CrossRefPubMed
15.
go back to reference Bader MJ, Tilki D, Gratzke C, Sroka R, Stief CG, Reich O: Ho:YAG-laser: treatment of vesicourethral strictures after radical prostatectomy. World J Urol. 2010, 28: 169-172. 10.1007/s00345-010-0520-z.CrossRefPubMed Bader MJ, Tilki D, Gratzke C, Sroka R, Stief CG, Reich O: Ho:YAG-laser: treatment of vesicourethral strictures after radical prostatectomy. World J Urol. 2010, 28: 169-172. 10.1007/s00345-010-0520-z.CrossRefPubMed
16.
go back to reference Hayashi T, Yoshinaga A, Ohno R, Ishii N, Watanabe T, Yamada T, Kihara K: Successful treatment of recurrent vesicourethral stricture after radical prostatectomy with holmium laser: report of three cases. Int J Urol. 2005, 12: 414-416. 10.1111/j.1442-2042.2005.01053.x.CrossRefPubMed Hayashi T, Yoshinaga A, Ohno R, Ishii N, Watanabe T, Yamada T, Kihara K: Successful treatment of recurrent vesicourethral stricture after radical prostatectomy with holmium laser: report of three cases. Int J Urol. 2005, 12: 414-416. 10.1111/j.1442-2042.2005.01053.x.CrossRefPubMed
17.
go back to reference Lagerveld BW, Laguna MP, Debruyne FM, De La Rosette JJ: Holmium:YAG laser for treatment of strictures of vesicourethral anastomosis after radical prostatectomy. J Endourol. 2005, 19: 497-501. 10.1089/end.2005.19.497.CrossRefPubMed Lagerveld BW, Laguna MP, Debruyne FM, De La Rosette JJ: Holmium:YAG laser for treatment of strictures of vesicourethral anastomosis after radical prostatectomy. J Endourol. 2005, 19: 497-501. 10.1089/end.2005.19.497.CrossRefPubMed
Metadata
Title
Recurrent urethrovesical anastomotic strictures following artificial urinary sphincter implantation: a case report
Authors
Ioannis Adamakis
Stavros I Tyritzis
Ioanna Vasileiou
Ioannis Katafigiotis
Ioannis Leotsakos
Sotiria Fergadaki
Konstantinos G Stravodimos
Constantinos A Constantinides
Publication date
01-12-2012
Publisher
BioMed Central
Published in
Journal of Medical Case Reports / Issue 1/2012
Electronic ISSN: 1752-1947
DOI
https://doi.org/10.1186/1752-1947-6-94

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