Retropubic nerve and seminal sparing radical prostatectomy for recurrent bladder neck-prostatic urethra strictures.
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.
Graziotti
Pierpaolo
P
Department of Urology, Istituto Clinico Humanitas, Rozzano, Italy.
Giusti
Guido
G
Seveso
Mauro
M
Taverna
Gianluigi
G
Benetti
Alessio
A
Maugeri
Orazio
O
Pasini
Luisa
L
Zandegiacomo
Silvia
S
Piccinelli
Alessandro
A
Maffezzini
Massimo
M
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