Balloon dilatation of cicatricial bladder neck contracture: evaluation of the efficacy after transurethral prostate interventions (preliminary results)

Abstract

Introduction. Cicatricial bladder neck contracture (CBNC) is one of the most common complications after endoscopic prostate procedures. There is no consensus among urologists about which method is advisable to use in the treatment of postoperative CBNC — transurethral resection (TUR) or incision. In this regard, the study of balloon dilation is a promising alternative. Purpose of the study . To improve the results of balloon dilation in patients with CBNC after endoscopic surgery for BPH. Materials and methods. The study involved 34 patients with recurrent CBNC after TUR and laser enucleation. The patients were divided into 2 groups: group A (n = 16) included men who, after bladder neck's TUR, additionally underwent transurethral balloon dilatation, while control group B (n = 18) included men who were prescribed conservative therapy only using alpha-blockers. Results. 2 months after the bladder neck's TURP and 1 month after balloon dilatation in group A, the mean IPSS score was 14.2 ± 2.1, QoL was 2.9 ± 0.9, while in group B it was at the end of 2nd month after the bladder neck's TURP, these indicators were 16.2 ± 3.1 and 3.9 ± 0.8 points, respectively (p <0.05). The average maximum urine flow rate in group A was 15.8 ± 2.8 ml/sec, in group B was 11.6 ± 2.8 ml/sec (p <0.05). Also, a significant decrease in the residual urine volume was revealed from 43.4 ± 34.4 to 27.8 ± 12.5 ml in group A, while in group B this indicator decreased from 49.1 ± 30.2 to 30.2 ± 11.7 ml. Conclusions. The method of transurethral balloon dilatation in case of CBNC under TRUS control using local anaesthesia only avoids gross trauma to the urethra and bladder neck with a cystoscope or mechanical dilatator. It helps to reduce the likelihood and severity of complications of this treatment method.