Obliterative vesicourethral strictures following radical prostatectomy for prostate cancer: reconstructive armamentarium.
OBJECTIVE
We report the reconstructive techniques used to correct obliterative vesicourethral strictures related to prostate cancer surgery.


METHODS
Four men with anastomotic obliteration after radical prostatectomy underwent primary excision with end-to-end anastomosis, penile fasciocutaneous flap, free-graft urethroplasty with rectus muscle flap or anterior bladder tube with omental pedicle flap procedure.


RESULTS
At mean followup of 33.8 months all patients had urethral patency but none was continent.


CONCLUSIONS
Single stage reconstruction of the obliterated vesicourethral anastomosis after prostatectomy successfully restored urethral patency. No technique was applicable in all cases. Sphincteric function is likely to be compromised after the primary procedure, resulting in incontinence after successful urethral reconstruction. Subsequent artificial sphincter placement appears to be safe and helpful in restoring continence.
Wessells
H
H
Department of Urology, University of California School of Medicine and San Francisco General Hospital, 94110, USA.
Morey
A F
AF
McAninch
J W
JW
D000368:Aged; D000714:Anastomosis, Surgical / Q000009:adverse effects; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011468:Prostatectomy / Q000009:adverse effects*; D011471:Prostatic Neoplasms / Q000601:surgery*; D014521:Urethra / Q000601:surgery*; D014525:Urethral Stricture / Q000209:etiology* / Q000601:surgery*; D001743:Urinary Bladder / Q000601:surgery*; D001748:Urinary Bladder Neck Obstruction / Q000209:etiology* / Q000601:surgery*