[Management of vesicourethral anastomotic stenosis after radical prostatectomy]

Abstract

Vesicourethral anastomotic stenosis is a relatively uncommon problem after radical prostatectomy, but it could become recurrent and difficult to treat. Risk factors are known, and they can help to decrease the incidence. When discussing the therapeutic plan, we must consider the stenosis risk, and also the urinary continence after the prostatectomy. Many treatment schedules are proposed, some of them with low available evidence, limited to case series with different number of patient and follow-up length, or reviews on the subject. Endoscopic options are the commonest, obtaining different success rates depending on the incision, resection or vaporization of the tissue. They could also benefit from the use of adjuvant local injections of drugs regulating tissue growth. Recurrent or obliterated cases could require surgical reconstruction using perineal, abdominal or combined approaches, or even suprapubic urinary diversions.

Keywords: Bladder neck obstruction; Cáncer de próstata; Endoscopic surgical procedures; Estenosis de uretra posterior; Estenosis posprostatectomía; Obstrucción del cuello vesical; Posterior urethral stenosis; Postprostatectomy stenosis; Prostate cancer; Reconstructive surgical procedures; Técnicas quirúrgicas endoscópicas; Técnicas quirúrgicas reconstructivas.