Streamlined surgical approach for coexistent urethral stricture and benign prostatic enlargement: feasibility, safety and patency results.


Journal

World journal of urology
ISSN: 1433-8726
Titre abrégé: World J Urol
Pays: Germany
ID NLM: 8307716

Informations de publication

Date de publication:
25 Oct 2024
Historique:
received: 18 08 2024
accepted: 01 10 2024
medline: 26 10 2024
pubmed: 26 10 2024
entrez: 25 10 2024
Statut: epublish

Résumé

To evaluate the technical feasibility, safety, and patency results of a simultaneous surgical approach to repair urethral stricture and treat benign prostatic enlargement endoscopically in a highly selected group of patients at a tertiary referral center. We hypothesize that this is technically feasible, safe, and does not affect urethroplasty outcomes. A retrospective review of adult men who underwent simultaneous urethroplasty and endoscopic prostatic surgery between May 2017 and May 2024 at our institution was conducted. Patients with strictures < 15 French and prostates with adverse prognostic features of response to medical treatment were included. The primary outcome was technical feasibility and safety. The secondary outcome was stricture-free survival. Twenty men were treated during the study period. The median length of the urethral stricture was 3.0 cm (IQR 2.0-5.0), and the median size of the prostate was 95.0 cc (IQR 63.3-128.3). All patients were treated successfully with a median operative time of 194.5 min (IQR 180.0-246.8), and no procedures required conversion to a staged procedure or open prostatectomy. There were seven Clavien-Dindo I-II complications and one Clavien-Dindo IIIb complication (hematuria requiring endoscopic clot evacuation). At 22 months follow-up, two cases of urethral re-stricture were diagnosed, with one case requiring redo urethroplasty, though none had previous major complications. The combination of urethroplasty and endoscopic surgery for benign prostatic enlargement at the same stage appears to be technically viable and safe, and it does not compromise medium-term urethral patency results in a carefully selected group of patients.

Identifiants

pubmed: 39455449
doi: 10.1007/s00345-024-05306-5
pii: 10.1007/s00345-024-05306-5
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

594

Informations de copyright

© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

Références

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Auteurs

Jordán Scherñuk (J)

Genitourinary Reconstructive Surgery Division, Department of Urology, Hospital Italiano de Buenos Aires, Pres. Tte. Gral. Juan Domingo Perón 4190, C1199 ABH, Buenos Aires, Argentina. jordan.schernuk@hospitalitaliano.org.ar.

Juan Diego Tinajero (JD)

Genitourinary Reconstructive Surgery Division, Department of Urology, Hospital Italiano de Buenos Aires, Pres. Tte. Gral. Juan Domingo Perón 4190, C1199 ABH, Buenos Aires, Argentina.

Federico Tirapegui (F)

Genitourinary Reconstructive Surgery Division, Department of Urology, Hospital Italiano de Buenos Aires, Pres. Tte. Gral. Juan Domingo Perón 4190, C1199 ABH, Buenos Aires, Argentina.
Laser and Endourology Division, Department of Urology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.

Mariano Sebastián González (MS)

Laser and Endourology Division, Department of Urology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.

Carlos Roberto Giudice (CR)

Genitourinary Reconstructive Surgery Division, Department of Urology, Hospital Italiano de Buenos Aires, Pres. Tte. Gral. Juan Domingo Perón 4190, C1199 ABH, Buenos Aires, Argentina.

Gabriel Andrés Favre (GA)

Genitourinary Reconstructive Surgery Division, Department of Urology, Hospital Italiano de Buenos Aires, Pres. Tte. Gral. Juan Domingo Perón 4190, C1199 ABH, Buenos Aires, Argentina.

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