Vesicourethral Strictures After Radical Prostatectomy: Review of Treatment and Outcome
WACHIRA KOCHAKARN, M.D.*, KRISADA RATANA-OLARN, M.D.*, VIRA VISESHSINDH, M.D.*
Affiliation : * Division of Urology, Department of Surgery, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand.
Objective : Stricture of the vesicourethral anastomosis is a complication after radical prostatectomy. Urethral dilatation, internal urethrotomy, transurethral resection or laser therapy have been reported as the treatment for this complication. The objective of this study was to present our experience with the management of the vesicourethral stricture.
Materials and Methods : A retrospective study of 90 patients undergoing radical prostatec tomy for localized prostatic carcinoma was done. The vesicourethral stricture was treated by dilata tion, internal urethrotomy, and transurethral resection of scar tissue in all of the patients. Dilatation was done in less severe cases, internal urethrotomy was done in partial obliteration or after failure of dilatation. Transurethral resection was done in cases with long scar tissue.
Results : Ten patients ( 11%) had anastomotic stricture. The strictures were treated by dila tation in 5 cases, internal ur~otomy in 4 cases and transurethral resection in 1 case. Cure was achieved in all of the patients without incontinence. The median follow- up was 10 months (4-36 months)
Conclusion : The dilatation and endoscopic procedures of the vesicourethral stricture showed a high cure rate and low incidence of incontinence.
Keywords : Prostate, Carcinoma, Surgery, Radical Prostatectomy, Complication, Urethral Stricture
