title: Retropubic nerve and seminal sparing radical prostatectomy for recurrent bladder neck-prostatic urethra strictures.
abstract: OBJECTIVE
  To verify if nerve and seminal sparing radical prostatectomy could represent surgical solution for iatrogenic bladder neck prostatic urethra contracture without external sphincter involvement.
  
  
  METHODS
  At our institution 4 patients have been submitted to nerve and seminal sparing radical prostatectomy for recurrent bladder neck-prostatic urethra contracture following TURP for middle size adenoma. In all cases bladder neck was reconstructed and a 20F silicon catheter was left in place for two weeks to stint the vesico-urethral anastomosis.
  
  
  RESULTS
  In all cases no significant perioperative complications were experienced. A normal voiding urethrogram preceded removal of the catheter 14 days postoperatively. Urinary continence was recovered by all of the patients. Uroflowmetry was persistently normal at periodic controls. With a mean follow-up of 36.3 months, no patient complained of symptomatic recurrence of urinary obstruction. In three previously potent patients, sexual activity with satisfactory intercourse was maintained.
  
  
  CONCLUSIONS
  Even though our experience is very limited in terms of number of patients and length of follow-up, we think that nerve and seminal sparing radical prostatectomy, because of the limited risk of major complications and the good result in terms of preservation of both urinary continence and erectile function, can be a reasonable solution for iatrogenic bladder neck-prostatic contracture after prostatic surgery for BPH.
authors.affiliation: Department of Urology, Istituto Clinico Humanitas, Rozzano, Italy.
authors.forename: Pierpaolo
authors.initials: P
authors.lastname: Graziotti
authors.forename: Guido
authors.initials: G
authors.lastname: Giusti
authors.forename: Mauro
authors.initials: M
authors.lastname: Seveso
authors.forename: Gianluigi
authors.initials: G
authors.lastname: Taverna
authors.forename: Alessio
authors.initials: A
authors.lastname: Benetti
authors.forename: Orazio
authors.initials: O
authors.lastname: Maugeri
authors.forename: Luisa
authors.initials: L
authors.lastname: Pasini
authors.forename: Silvia
authors.initials: S
authors.lastname: Zandegiacomo
authors.forename: Alessandro
authors.initials: A
authors.lastname: Piccinelli
authors.forename: Massimo
authors.initials: M
authors.lastname: Maffezzini
mesh_terms: D000236:Adenoma / Q000601:surgery; D000368:Aged; D007172:Erectile Dysfunction / Q000517:prevention & control; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000601:surgery; D012008:Recurrence; D012189:Retrospective Studies; D012669:Seminal Vesicles; D020728:Transurethral Resection of Prostate / Q000009:adverse effects; D014521:Urethra / Q000294:innervation*; D014525:Urethral Stricture / Q000209:etiology / Q000601:surgery*; D001748:Urinary Bladder Neck Obstruction / Q000209:etiology / Q000601:surgery*; D014549:Urinary Incontinence / Q000517:prevention & control