AUA 2017: Charles Devine Lecture: Surgical Management of Anastomotic Stenosis After Radical Prostatectomy
Boston, MA (UroToday.com) Anastomotic stenosis after radical prostatectomy can be prevalent in up to 32% of patients. Typically patients present in the first six months after surgery. In order to plan the surgical approach to a repair, the urologist must establish the length, location and etiology of the stenosis. Endoscopic procedures can be attempted but can lead to significant incontinence and will make future urethroplasty more difficult. Prior to a definitive repair, Dr Cavalcanti performs cystoscopy, urethrogram and dynamic MRI. He finds the MRI delineates the stricture well allowing for better localization. He traditionally has favored a perineal approach as the success rates are higher compared to an abdominal approach. More recently he has begun using a prerectal approach, which he believes offers better access to the bladder neck and allows more urethral mobilization with vascular preservation. As this dissection avoids the bulbar urethra, it allows for successful placement of an artificial urinary sphincter in the traditional bulbar location.
Presented By: Andre Cavalcanti, MD
Written By: Lisa Parrillo, MD, Genitourinary Reconstructive Surgery Fellow, University of Colorado
at the 2017 AUA Annual Meeting - May 12 - 16, 2017 – Boston, Massachusetts, USA