Sourial MW, et al. – Aim of this study was to propose a simple, minimally invasive treatment option for recurrent vesicourethral anastomotic stenosis (VUAS) post–RP. It was concluded that MMC injection with urethral dilatation is a safe, effective, and minimally invasive treatment option for recurrent vesicourethral anastomotic stenosis after radical prostatectomy. In addition, favorable long–term results can be expected even after anti–incontinence procedures.

Methods

• In this longitudinal case series, researchers included a sum of 29 patients with postprostatectomy incontinence and diagnosed with recurrent VUAS between March 2009 and January 2014.
• Under sedation, MMC was injected at the 3, 6, and 9 o’clock position, followed by urethral dilatation to 26 F.
• They conducted cystoscopy to assess for patency at set intervals.
• In this study, patients had the possibility to receive a salvage MMC injection whether recurrence was noted.
• Patients with resolved VUAS were offered an anti–incontinence surgery.

Results

• 67 years (63–72) was the median (interquartile range [IQR]) patient age.
• It was suggested that 17 patients had ≥2 prior treatments for the VUAS (median = 2, IQR: 1–3 treatments); 23 patients (79%) had a patent bladder neck at the 12 months follow–up cystoscopy after a single MMC injection and dilatation.
• The data confirmed that 3 patients opted for a salvage MMC injection for recurrence, and 2 of those were salvaged, improving the success rate to 86%.
• There were no adverse events.
• It was illustrated that overall 20 patients (69%) opted for an anti–incontinence surgery, and all were either cured or improved of their incontinence after a median (IQR) follow–up of 58 months (48–77).