Bipolar transurethral resection of anastomotic strictures after radical prostatectomy.
OBJECTIVE
The efficacy of the bipolar endoscopic resection for anastomotic stricture was assessed and compared with holmium laser treatment.


METHODS
We studied a cohort of 39 patients with anastomotic strictures in years 1999 to 2007. Twenty-two patients had undergone bipolar resection, and 17 patients had undergone holmium laser treatment. The mean age of the bipolar cohort was 63.8 years; initial prostate-specific antigen (PSA) level was 10.7 ng/mL. The mean age of the laser cohort was 64 years; initial PSA level was 7.8 ng/mL. The results were evaluated by measurement of the maximum urinary flow (Qmax) and the postvoid residual volume of urine (PVR) before surgery, and at 6 weeks and 6 months after surgery. The Wilcoxon rank-sum test was used for statistical analysis, and a P value <0.05 was considered significant.


RESULTS
The mean follow-up period was 42 (14-74) months. Improvements in Qmax and PVR were recorded in the two cohorts. In the bipolar cohort, the mean values of Qmax were 3.9 mL/s, 14 mL/s, and 13 ml/s, while PVR values were 46 mL, 10 mL, and 11 mL. The mean values of Qmax in the laser cohort were 3.7 mL/s, 11 mL/s and 6.1 mL/s; PVR were 25 mL, 16 mL, and 19 mL. Statistically significantly better results of Qmax over 6 months were in the bipolar cohort (P < 0.001). No perioperative complications and no deterioration of urinary continence were recorded.


CONCLUSIONS
The bipolar resection of an anastomotic stricture is a highly effective method that produces better long-term results than the holmium laser treatment.
Brodak
Milos
M
Department of Urology, University Hospital, Hradec Kralove, Czech Republic. brodak@fnhk.cz
Kosina
Josef
J
Pacovsky
Jaroslav
J
Navratil
Pavel
P
Holub
Lukas
L
D000714:Anastomosis, Surgical / Q000009:adverse effects; D003251:Constriction, Pathologic / Q000209:etiology / Q000601:surgery; D003710:Demography; D006801:Humans; D053685:Laser Therapy; D053844:Lasers, Solid-State; D008297:Male; D008875:Middle Aged; D011467:Prostate / Q000503:physiopathology / Q000601:surgery*; D011468:Prostatectomy / Q000009:adverse effects* / Q000379:methods*; D020728:Transurethral Resection of Prostate / Q000379:methods*; D014554:Urination / Q000502:physiology