Vesicourethral strictures after radical prostatectomy: review of treatment and outcome.
OBJECTIVE
Stricture of the vesicourethral anastomosis is a complication after radical prostatectomy. Urethral dilatation, internal urethrotomy, transurethral resection or laser therapy have been reported as the treatment for this complication. The objective of this study was to present our experience with the management of the vesicourethral stricture.


METHODS
A retrospective study of 90 patients undergoing radical prostatectomy for localized prostatic carcinoma was done. The vesicourethral stricture was treated by dilatation, internal urethrotomy, and transurethral resection of scar tissue in all of the patients. Dilatation was done in less severe cases, internal urethrotomy was done in partial obliteration or after failure of dilatation. Transurethral resection was done in cases with long scar tissue.


RESULTS
Ten patients (11%) had anastomotic stricture. The strictures were treated by dilatation in 5 cases, internal urethrotomy in 4 cases and transurethral resection in 1 case. Cure was achieved in all of the patients without incontinence. The median follow-up was 10 months (4-36 months)


CONCLUSIONS
The dilatation and endoscopic procedures of the vesicourethral stricture showed a high cure rate and low incidence of incontinence.
Kochakarn
Wachira
W
Department of Surgery, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Ratana-Olarn
Krisada
K
Viseshsindh
Vira
V
D000230:Adenocarcinoma / Q000175:diagnosis / Q000601:surgery; D000368:Aged; D000714:Anastomosis, Surgical / Q000009:adverse effects; D002404:Catheterization / Q000379:methods; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011468:Prostatectomy / Q000009:adverse effects* / Q000379:methods*; D011471:Prostatic Neoplasms / Q000175:diagnosis / Q000601:surgery; D012086:Reoperation / Q000379:methods; D012189:Retrospective Studies; D018570:Risk Assessment; D016896:Treatment Outcome; D014525:Urethral Stricture / Q000209:etiology* / Q000628:therapy*