Management of Bladder Neck Stenosis Secondary to Radical Prostatectomy or Radiation Treatment

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• 作者：Jessica DeLong (1) (2)
  Kurt McCammon (1) (2)
  
• 关键词：Bladder neck contracture ; Bladder neck stenosis ; Urethral stricture ; Brachytherapy ; Radical prostatectomy ; Urethral stricture ; Prostate cancer ; Radiation ; Urethroplasty
• 刊名：Current Bladder Dysfunction Reports
• 出版年：2014
• 出版时间：September 2014
• 年：2014
• 卷：9
• 期：3
• 页码：227-233
• 全文大小：333 KB
• 参考文献：1. SEER Cancer Statistics Factsheets: prostate cancer. National Cancer Institute. Bethesda, MD,http://seer.cancer.gov/statfacts/html/prost.html.
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• 作者单位：Jessica DeLong (1) (2)
  Kurt McCammon (1) (2)
  
  1. Adult and Pediatric Reconstructive Surgery, Eastern Virginia Medical School, Norfolk Virginia, Norfolk, VA, USA
  2. 225 Clearfield Avenue, Virginia Beach, VA, 23462, USA
  
• ISSN：1931-7220

文摘

Bladder neck stenosis (BNS) and posterior urethral stenosis (PUS) are uncommon but problematic complications of treatment for localized prostate cancer. Overall, BNS is less common following minimally invasive radical prostatectomy than open. Patients who develop PUS following radiation therapy (RT) (especially salvage RT) pose a greater challenge and tend to present longer after treatment. Regardless of etiology, treatment begins conservatively with endoscopic management but quickly progresses to more aggressive intervention if refractory. Urethral stents have been used with acceptable results. In patients who fail conservative therapy after radical prostatectomy (RP), open reconstruction should be considered. After RT, patients may ultimately benefit from urinary diversion or salvage prostatectomy. After treatment, many patients will require implantation of artificial urinary sphincter (AUS) for management of incontinence. Patient counseling prior to treatment selection for initial prostate cancer therapy is important; complications, future management, and potential for return to normal quality of life vary widely.