Management of bladder neck stenosis and urethral stricture and stenosis following treatment for prostate cancer

Transl Androl Urol. 2017 Jul;6(Suppl 2):S92-S102. doi: 10.21037/tau.2017.04.33.

Abstract

The aim of this review is to examine all urethral strictures and stenoses subsequent to treatment for prostate cancer, including radical prostatectomy (RP), radiotherapy, high intensity focused ultrasound (HIFU) and cryotherapy. The overall majority respond to endoscopic treatment, including dilatation, direct visual internal urethrotomy (DVIU) or bladder neck incision (BNI). There are adjunct treatments to endoscopic management, including injections of corticosteroids and mitomycin C (MMC) and urethral stents, which remain controversial and are not currently mainstay of treatment. Recalcitrant strictures are most commonly managed with urethroplasty, while recalcitrant stenosis is relatively rare yet almost always associated with bothersome urinary incontinence, requiring bladder neck reconstruction and subsequent artificial urinary sphincter (AUS) implantation, or urinary diversion for the devastated outlet.

Keywords: Prostate cancer; bladder neck stenosis; urethral stenosis; urethral stricture.

Publication types

  • Review