Management of anastomotic stricture after artificial urinary sphincter placement in patients who underwent salvage prostatectomy Journal Article


Authors: Weissbart, S. J.; Chughtai, B.; Elterman, D.; Sandhu, J. S.
Article Title: Management of anastomotic stricture after artificial urinary sphincter placement in patients who underwent salvage prostatectomy
Abstract: Objective: To report on a safe endoscopic management technique for the treatment of an anastomotic stricture (AS) in patients with an artificial urinary sphincter (AUS). Methods: Five patients with a history of salvage prostatectomy after radiation therapy that developed an AS after AUS placement were treated with a rigid ureteroscope and a Holmium YAG (Ho: YAG) laser to incise the AS. The AUS was opened and deactivated but not decoupled or removed during the procedure. The rigid ureteroscope allowed complete control of the laser fiber to incise the stricture at the 3 and 9 o' clock positions and then circumferentially. Results: There were no intraoperative complications and the mean operative time was 42.6 minutes. Of the 5 patients who underwent holmium laser incision of an AS after AUS placement, none developed AUS malfunction or required device replacement. No patients reported worsening of urinary incontinence after treatment. Two patients required repeat holmium laser incision for AS recurrence. Conclusion: Using a rigid ureteroscope and a holmium laser to incise an AS after AUS placement seems to be a safe management option that does not damage the AUS or result in worsening incontinence. This treatment strategy provides an endoscopic alternative to using open surgical technique to uncouple or remove the AUS while treating the AS. © 2013 Elsevier Inc. All Rights Reserved.
Keywords: adult; clinical article; aged; middle aged; surgical technique; salvage therapy; radiotherapy; postoperative complication; prostatic neoplasms; prostatectomy; urinary bladder; cystoscopy; urethra; anastomosis, surgical; anastomotic stricture; incontinence; holmium laser; bladder sphincter prosthesis; urinary sphincter, artificial; urodynamics; urethral stricture; lasers, solid-state; rigid ureteroscope; ureteroscopes
Journal Title: Urology
Volume: 82
Issue: 2
ISSN: 0090-4295
Publisher: Elsevier Science, Inc.  
Date Published: 2013-08-01
Start Page: 476
End Page: 479
Language: English
DOI: 10.1016/j.urology.2013.03.012
PROVIDER: scopus
PUBMED: 23683997
DOI/URL:
Notes: --- - "Export Date: 4 September 2013" - "CODEN: URGYA" - "Source: Scopus"
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  1. Jaspreet Sandhu
    120 Sandhu