title: [Perineal, endoscopic desobliteration of a complete anastomotic stricture following a salvage radical prostatectomy].
abstract: BACKGROUND
  Anastomotic strictures are a known complication following a radical prostatectomy for prostate cancer. In rare cases there can be a complete displacement of the urethral anastomosis region. Treating this obstruction poses a technical challenge. Therapy includes open reconstruction of the bladder neck, continent stoma but also often only a suprapubic urinary diversion. A problem occurs when precisely this diversion has to be removed.
  
  
  METHODS
  We report on a 68-year-old patient who, due to recurrent post operative and post radiogenic anastomotic strictures, has been fitted with a suprapubic urinary drainage device. Following an infection that spread locally, the patient developed symphysitis that had to be treated surgically. As a result, it became necessary to switch the urine drainage system. As a result of a perineal puncture of the urethra and scarring obliteration into the bladder it was possible to establish a transurethral catheter. The needle was guided by means of endoscopic view and transrectal ultrasound.
  
  
  CONCLUSIONS
  This case demonstrates a method to re-establish a transurethral urinary diversion in cases of complete anastomotic strictures.
authors.affiliation: Urologische Abteilung Segeberger Kliniken, Bad Segeberg. ruediger.gleichmann@segebergerkliniken.de
authors.forename: R
authors.initials: R
authors.lastname: Gleichmann
authors.forename: P
authors.initials: P
authors.lastname: Gasirabo
mesh_terms: D002408:Catheters, Indwelling; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D004724:Endoscopy / Q000379:methods*; D006801:Humans; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D009364:Neoplasm Recurrence, Local / Q000601:surgery*; D009367:Neoplasm Staging; D010502:Perineum / Q000601:surgery; D011183:Postoperative Complications / Q000601:surgery*; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D018714:Radiotherapy, Adjuvant; D012086:Reoperation; D016879:Salvage Therapy; D014521:Urethra / Q000601:surgery; D014525:Urethral Stricture / Q000601:surgery*; D014547:Urinary Diversion; D014567:Urography