Vesicourethral Anastomotic Stenosis after Prostate Cancer Treatment

AbstractPurpose of ReviewTo describe the epidemiology, pathogenesis, and management of vesicourethral anastomotic stenosis after prostate cancer treatment.Recent FindingsInjectable scar modulating agents administered at the time of direct visual internal urethrotomy of vesicourethral anastomotic stenoses have been shown to improve endoscopic treatment outcomes. Trials are ongoing to find the optimal agent and delivery system. Novel tissue engineering techniques are in development and hold promise.SummaryVesicourethral anastomotic stenosis after the treatment of prostate cancer is a challenging complication for patients and urologists. Stenoses are prone to recurrence after endourologic treatment. Open repair is technically demanding and carries substantial patient morbidity. The need for adjuvant or salvage radiation therapy after radical prostatectomy worsens outcomes of both endourologic and formal repairs. Postoperative worsening of urinary incontinence is common after vesicourethral anastomotic stenosis repair and can ultimately require placement of an artificial urinary sphincter or male sling. Occasionally urinary diversion, indwelling foley catheter, or clean intermittent catheterization is necessary when reconstructive options have been exhausted. Adjunctive measures to improve endourologic management such as hyperbaric oxygen and transurethral injection of anti-fibrotic agents have been an area of interest in recent years and show promise.

Source: Current Bladder Dysfunction Reports - October 24, 2019 Category: Urology & Nephrology Source Type: research