The T-plasty as therapy for recurrent bladder neck stenosis: success rate, functional outcome, and patient satisfaction.

Abstract

PURPOSE:

To determine success rate (SR), functional outcome, and patient satisfaction of a modified YV-plasty for reconstruction of the bladder neck in case of recurrent bladder neck stenosis (BNS) after transurethral surgery of the prostate: the T-plasty.

PATIENTS AND METHODS:

We identified all patients who underwent T-plasty at our center between December 2008 and July 2016. Patients' charts were reviewed. Patients were queried by telephone and by mail at time of follow-up (FU). Primary endpoint was SR. Secondary endpoints were complications, continence, satisfaction, and changes in quality of life measured by validated questionnaires.

RESULTS:

Thirty patients underwent the T-plasty. Median age at surgery was 69 (IQR 62-73) years. Most patients had BNS due to TUR-P [n = 25 (83.3%)]. No severe blood loss or severe complications occurred perioperatively. Median FU was 45 (IQR 18-64) months. Three patients were lost to FU. Success rate was 100%. Compared to pre-OP Q max, mean Q max post-OP improved significantly [pre-OP 6.79 (SD ± 4.76) ml/s vs post-OP was 24.42 (SD ± 12.61) ml/s; (t(5) = 4.12, p = 0.009)]. Mean post-void residual urine decreased significantly [pre-OP 140.77 (SD ± 105.41) ml vs post-OP 14.5 (SD ± 22.42) ml; (t(9) = -3.86, p = 0.004)]. One patient developed a de-novo-incontinence post-OP. Mean ICIQ-SF Score was 1.2 (SD ± 2.27). 88.5% of patients were pleased or delighted by surgery. 75% of patients claimed their quality of life has been (strongly) improved.

CONCLUSIONS:

The T-plasty is a valuable option as treatment of recurrent BNS. SR, rates of continence, and high patient satisfaction are very encouraging.

• Authors: Clemens M Rosenbaum, Roland Dahlem, Valentin Maurer, Luis A Kluth, Malte W Vetterlein, Margit Fisch, Victor Schuettfort, C Philip Reiss
• Journal: World journal of urology (World J Urol) Vol. 35 Issue 12 Pg. 1907-1911 (Dec 2017) ISSN: 1433-8726 [Electronic] Germany
• PMID: 28929299 (Publication Type: Journal Article)

Topics

• Aged
• Follow-Up Studies
• Germany (epidemiology)
• Humans
• Male
• Patient Preference
• Postoperative Complications (diagnosis, physiopathology, psychology, surgery)
• Prostatic Hyperplasia (epidemiology, surgery)
• Quality of Life
• Plastic Surgery Procedures (adverse effects, methods)
• Recovery of Function
• Recurrence
• Reoperation (adverse effects, methods)
• Transurethral Resection of Prostate (adverse effects, methods)
• Treatment Outcome
• Urinary Bladder Neck Obstruction (diagnosis, etiology, physiopathology, surgery)
• Urinary Incontinence (diagnosis, etiology)
• Urinary Retention (diagnosis, etiology)