Anastomotic strictures following radical prostatectomy: risk factors and management.
Stricture of the anastomosis between the bladder neck and membranous urethra after radical prostatectomy can cause significant voiding dysfunction. Of 156 patients undergoing radical prostatectomy for localized prostatic carcinoma 18 had anastomotic stricture for an over-all incidence of 11.5%. The risk factors for anastomotic stricture and the treatment outcome in these patients were analyzed. Excessive intraoperative blood loss, extravasation of urine at the anastomotic site and a prior transurethral prostatic operation significantly contributed to the development of stricture. More than half of the patients did not respond to simple dilation alone. Cold knife incision of the stricture by itself was effective in only 62% of the patients. The remaining patients required periodic dilation to maintain an adequate urine flow. Incision of the stricture with electrocautery resulted in urinary incontinence in all patients.
Surya
B V
BV
Urology Service, Department of Veterans Affairs Medical Center, New York, New York.
Provet
J
J
Johanson
K E
KE
Brown
J
J
D000714:Anastomosis, Surgical / Q000009:adverse effects; D004106:Dilatation; D006801:Humans; D008297:Male; D011468:Prostatectomy / Q000009:adverse effects*; D011471:Prostatic Neoplasms / Q000601:surgery; D012086:Reoperation; D012307:Risk Factors; D014521:Urethra / Q000601:surgery; D014525:Urethral Stricture / Q000209:etiology / Q000601:surgery / Q000628:therapy*; D001743:Urinary Bladder / Q000601:surgery; D001748:Urinary Bladder Neck Obstruction / Q000209:etiology / Q000628:therapy*