MP19-04 MANAGEMENT OF INTRACTABLE BLADDER NECK STRICTURES FOLLOWING RADICAL PROSTATECTOMY

Abstract

You have accessJournal of UrologyProstate Cancer: Localized: Surgical Therapy I (MP19)1 Apr 2020MP19-04 MANAGEMENT OF INTRACTABLE BLADDER NECK STRICTURES FOLLOWING RADICAL PROSTATECTOMY Arjun Nathan*, Giorgio Mazzon, Nicola Pavan, Ruben De Groote, Ashwin Sridhar, and Senthil Nathan Arjun Nathan*Arjun Nathan* More articles by this author , Giorgio MazzonGiorgio Mazzon More articles by this author , Nicola PavanNicola Pavan More articles by this author , Ruben De GrooteRuben De Groote More articles by this author , Ashwin SridharAshwin Sridhar More articles by this author , and Senthil NathanSenthil Nathan More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000852.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The incidence of Vesicourethral Anastomotic Stenosis (VUAS) post radical prostatectomy varies from 1% to 26%. Current treatment can be challenging and include a variety of different procedures. These range from endoscopic dilations to bladder neck reconstruction to urinary diversion. We investigated a 2-stage endoscopic treatment, using the thermo-expandable Memokath®045 bladder neck stent to manage patients with VUAS post radical prostatectomy. To retrospectively review 30 patients who underwent a Memokath®045 stent insertion for VUAS with a minimum of 12 months follow-up. METHODS: All patients had two previous attempts at endoscopic dilatation with or without incision and a trial of clean intermittent catheterisation. During the stage 1, the bladder neck stricture is dilated to diameter of 30Fr, the stricture length is measured, and a catheter is left in-situ. One to two weeks later, post haemostasis and healing, an appropriately sized Memokath®045 stent is inserted. The stent is then removed 1-year post-op. RESULTS: Our series of patients had a median age of 62 (54-72). Most patients (26) had a robot assisted radical prostatectomy (RARP) or salvage procedure. The mean interval time between prostatectomy and Memokath®045 stent insertion was 13 months. The mean follow-up time was 3.6 years with all patients having a minimum of 12 months follow-up. Results showed improvement in IPSS scores, IPSS quality of life scores, Qmax and PVR after the Memokath®045 stent was removed compared to pre-operation. With a minimum 12 months post stent removal, 93% of patients were fully continent, whilst 7% of patients were socially continent. 2 (7%) patients had their stents removed and not replaced due to re-stricturing and stone formation. However, no urinary tract infections, stricture recurrence or urinary retention was observed in the rest of the cohort (93%). CONCLUSIONS: Overall, the Memokath®045 stent was successful in treating 93% of our patients with VUAS. Our series had minimal complications that were managed with conservative measures and in 3 patients’ re-operation was needed. In conclusion, the Memokath®045 stent is less invasive than other techniques such as bladder neck reconstruction and urinary diversion and provides superior patency results. Therefore, this management option should be considered in the management of VUAS. Source of Funding: N/A © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e299-e299 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Arjun Nathan* More articles by this author Giorgio Mazzon More articles by this author Nicola Pavan More articles by this author Ruben De Groote More articles by this author Ashwin Sridhar More articles by this author Senthil Nathan More articles by this author Expand All Advertisement PDF downloadLoading ...