title: Bladder neck contracture after surgery for benign prostatic obstruction.
abstract: BACKGROUND
  Over the last few decades, numerous surgical procedures have been proposed to treat lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH). However, all are characterized by a certain rate of treatment failure due to bladder neck contracture (BNC). Treatment of secondary BNC appears to be challenging. The main purpose of this review is to evaluate current published knowledge on this topic.
  
  
  METHODS
  The MEDLINE/PubMed database was searched for all original articles published between 2000 and 2016 analyzing the incidence, prevalence and management of BNC as a post-operative complication following surgical treatment of LUTS/BPH. Prospectively designed studies, and those with prospectively maintained databases and/or rigorous inclusion and exclusion criteria were included. Given the lack of prospective studies examining treatment options for BNC, retrospective studies were also included in this section.
  
  
  RESULTS
  Thirty-four studies were included. The huge heterogeneity of patients, gland characteristics, surgical strategies and follow-up procedures limited the overall quality of results. BNC incidence after surgery for LUTS/BPH ranges from 0% to 9.6%. Given the dearth of well-designed studies, it seems rational to leave the choice of treatment procedure to the specialist's own decision.
  
  
  CONCLUSIONS
  BNC incidence varies greatly depending on the examined cohorts, with only few precautionary measures available for prevention. Treatment is challenging and it seems reasonable to leave the choice of BNC treatment technique to the surgeon's own judgement.
authors.affiliation: Robotic Unit, Department of Urology, ASL Abruzzo 2, SS. Annunziata Hospital, Chieti, Italy - lucacindolo@virgilio.it.
authors.forename: Luca
authors.initials: L
authors.lastname: Cindolo
authors.affiliation: Department of Urology, SS. Annunziata Hospital, G. D'Annunzio University, Chieti, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Marchioni
authors.affiliation: Department of Urology, Tenon Hospital, Université Pierre et Marie Curie Paris IV, Paris, France.
authors.forename: Esteban
authors.initials: E
authors.lastname: Emiliani
authors.affiliation: Department of Urology, SS. Annunziata Hospital, G. D'Annunzio University, Chieti, Italy.
authors.forename: Piergustavo
authors.initials: P
authors.lastname: DE Francesco
authors.affiliation: Department of Urology, SS. Annunziata Hospital, G. D'Annunzio University, Chieti, Italy.
authors.forename: Giulia
authors.initials: G
authors.lastname: Primiceri
authors.affiliation: Robotic Unit, Department of Urology, ASL Abruzzo 2, SS. Annunziata Hospital, Chieti, Italy.
authors.forename: Pietro
authors.initials: P
authors.lastname: Castellan
authors.affiliation: Robotic Unit, Department of Urology, ASL Abruzzo 2, SS. Annunziata Hospital, Chieti, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Schips
mesh_terms: D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods; D059411:Lower Urinary Tract Symptoms / Q000601:surgery; D008297:Male; D011183:Postoperative Complications / Q000209:etiology; D011468:Prostatectomy / Q000009:adverse effects* / Q000379:methods; D011470:Prostatic Hyperplasia / Q000601:surgery*; D001748:Urinary Bladder Neck Obstruction / Q000209:etiology*