F Campos-Juanatey1, J A Portillo Martín2, R Gómez Illanes3, L Velarde Ramos4. 1. Servicio de Urología, Hospital Universitario Marqués de Valdecilla, Santander, España. Electronic address: fcampos@humv.es. 2. Servicio de Urología, Hospital Universitario Marqués de Valdecilla, Santander, España; Facultad de Medicina, Universidad de Cantabria, Santander, España. 3. Servicio de Urología, Hospital del Trabajador, Santiago, Chile; Universidad Andrés Bello, Santiago, Chile. 4. Servicio de Urología, Hospital del Trabajador, Santiago, Chile.
Abstract
INTRODUCTION: Posterior urethral stenoses and contractures are complications after treatment of benign prostatic hyperplasia (BPH), localised prostate cancer (PCa), and orthotopic neobladder formation, compromising prognosis and functional outcomes. OBJECTIVES: To identify factors related to aetiology, prevention and treatment of non-traumatic posterior urethral stenosis and contractures. ACQUISITION OF EVIDENCE: Review of the published evidence related to posterior urethral stenosis and contractures after PCa treatment, BPH therapies and orthotopic neobladder formation. PubMed database search with English and Spanish papers considered. Cohort studies, case series, prospective and retrospective studies and review papers were included. SYNTHESIS OF EVIDENCE: Posterior urethral stenoses and contractures are common, leading to significant morbidity. A worsening on voiding quality should rise some concerns. Careful surgical and/or radiotherapic techniques prevent their development. Endoscopic therapies are the initial approach, with complex urethroplasties often required. Subsequent urinary incontinence, the most important sequelae, may need artificial sphincters. CONCLUSIONS: Non-traumatic posterior urethral stenoses could be important complications, potentially compromising the outcomes of initial therapy. They could require complex surgeries leading to urinary incontinence.
INTRODUCTION: Posterior urethral stenoses and contractures are complications after treatment of benign prostatic hyperplasia (BPH), localised prostate cancer (PCa), and orthotopic neobladder formation, compromising prognosis and functional outcomes. OBJECTIVES: To identify factors related to aetiology, prevention and treatment of non-traumatic posterior urethral stenosis and contractures. ACQUISITION OF EVIDENCE: Review of the published evidence related to posterior urethral stenosis and contractures after PCa treatment, BPH therapies and orthotopic neobladder formation. PubMed database search with English and Spanish papers considered. Cohort studies, case series, prospective and retrospective studies and review papers were included. SYNTHESIS OF EVIDENCE: Posterior urethral stenoses and contractures are common, leading to significant morbidity. A worsening on voiding quality should rise some concerns. Careful surgical and/or radiotherapic techniques prevent their development. Endoscopic therapies are the initial approach, with complex urethroplasties often required. Subsequent urinary incontinence, the most important sequelae, may need artificial sphincters. CONCLUSIONS: Non-traumatic posterior urethral stenoses could be important complications, potentially compromising the outcomes of initial therapy. They could require complex surgeries leading to urinary incontinence.