You have accessJournal of UrologyTrauma/Reconstruction/Diversion: Urethral Reconstruction (including Stricture, Diverticulum) II (PD22)1 Sep 2021PD22-04 LONG-TERM FOLLOW-UP AND FUNCTIONAL OUTCOMES OF THE T PLASTY FOR RECALCITRANT BLADDER NECK STENOSES Frederik König, Roland Dahlem, Phillip Marks, Lennart Kühnke, Maryam Khonsari, Margit Fisch, and Malte W. Vetterlein Frederik KönigFrederik König More articles by this author , Roland DahlemRoland Dahlem More articles by this author , Phillip MarksPhillip Marks More articles by this author , Lennart KühnkeLennart Kühnke More articles by this author , Maryam KhonsariMaryam Khonsari More articles by this author , Margit FischMargit Fisch More articles by this author , and Malte W. VetterleinMalte W. Vetterlein More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002011.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: There is a non-negligible proportion of men with recalcitrant bladder neck stenoses following treatment for benign prostatic hyperplasia (BPH) refractory to transurethral resections. We here present the long-term follow-up of our T-shaped modification of the YV plasty. METHODS: We included men with recurrent bladder neck stenoses following transurethral treatment for BPH who underwent the T plasty between 2008-19. Via a retropubic approach, the anterior bladder wall is opened by a T-shaped incision after scar excision and two well-vascularized bladder wall flaps are connected to the prostatic apex. This is supplemented by dorsal mucomucosal anastomosis of trigone and the prostatic cavity. We assessed clinical and surgical parameters to characterize our cohort. Validated patient-reported outcomes (ICIQ-UI SF, 6-item LUTS score, and treatment satisfaction) were assessed and recurrence was defined as surgical re-intervention due to recurrence at the bladder neck. RESULTS: Overall, 48 men underwent T plasty at a median age of 69 yr and 26 men (54%) had a Charlson index of 0. Median number of prior bladder neck resections was 3 (IQR 2–4) and median time from last resection was 5 mo (IQR 4–8). Of all patients, 9 (18%) had a hx of previous open urethral reconstruction and 4 (8.4%) were redo procedures with hx of previous YV plasty. At admission, 36 (75%) had a suprapubic catheter and median preoperative Qmax was 7.3 ml/s. Median operative time was 98 min, the procedure was performed by two experienced reconstructive surgeons, and median postoperative Qmax was 25 ml/s. At a median follow-up of 67 mo, treatment success was 94%. Of 3 recurring patients, 1 received a suprapubic catheter and 2 were treated endoscopically. PROMs were available in 43 men. According to the ICIQ-UI SF, 27 men (63%) reported full continence and median ICIQ-UI sum score (0-21) was 0 (0-4). Overall, 37 men (86%) were (very) satisfied with the surgical outcome and 19 (45%) reported normalization of urinary stream. Median 6-item LUTS score (0-24) was 2 (IQR 2–3), indicating a restored postoperative voiding function. CONCLUSIONS: We confirm the durable efficacy of the T plasty as salvage therapeutical approach in men who suffer from recurrent bladder neck stenoses refractory to conventional endoscopic interventions. Through the utilization of a bilateral bladder flap after T-shaped incision, a wide and tension-free bladder neck may be established leading to excellent and durable outcomes. The T plasty is a valid last resort alternative to permanent urinary diversion and warrants robotic adoption and validation. Source of Funding: n/a © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e381-e381 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Frederik König More articles by this author Roland Dahlem More articles by this author Phillip Marks More articles by this author Lennart Kühnke More articles by this author Maryam Khonsari More articles by this author Margit Fisch More articles by this author Malte W. Vetterlein More articles by this author Expand All Advertisement Loading ...