https://doi.org/10.4081/aiua.2024.12829

Outcomes of transperineal reanastomosis as a salvage treatment for recurrent vesicourethral anastomosis stenosis after radical prostatectomy

Vol. 96 No. 4 (2024)
Submitted: July 18, 2024
Accepted: August 26, 2024
Published: October 29, 2024
Transperineal reanastomosis, vesicourethral anastomosis stenosis, radical prostatectomy complications
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Authors

Piotr Gwara
https://orcid.org/0009-0006-2605-9088
Department of Urology, Centre of Postgraduate Medical Education, Independent Public Hospital of Prof. W. Orlowski, Warsaw, Poland.
Łukasz Białek
https://orcid.org/0000-0002-1178-5216
Department of Urology, Centre of Postgraduate Medical Education, Independent Public Hospital of Prof. W. Orlowski, Warsaw, Poland.
Marta Rydzińska
https://orcid.org/0000-0002-3300-7538
Department of Urology, Centre of Postgraduate Medical Education, Independent Public Hospital of Prof. W. Orlowski, Warsaw, Poland.
Jakub Dobruch
Department of Urology, Centre of Postgraduate Medical Education, Independent Public Hospital of Prof. W. Orlowski, Warsaw, Poland.
Michał Andrzej Skrzypczyk
michalskrzypczyk@gmail.com
https://orcid.org/0000-0001-9781-1907
Department of Urology, Centre of Postgraduate Medical Education, Independent Public Hospital of Prof. W. Orlowski, Warsaw, Poland.

Purpose: To evaluate transperineal reanastomosis (TRPA) combined with incontinence surgery as a complex treatment for recurring vesicourethral anastomosis stenosis (VUAS) after radical prostatectomy (RP).

Methods: Retrospective analysis of 8 patients who underwent TRPA for recurring VUAS. Detailed preoperative and follow up data were assessed.

Results: Mean follow up lasted 47 months (range 17-77) with mean age being 63.4 years (range 61-70). All patients achieved patency and 87.5% (7/8) maintained it to the end of follow up. However, four of them required additional procedures to retain patency. Six underwent incontinence surgery – artificial urinary sphincter (AUS) implantation – after which one cuff erosion occurred. In the end 62.5% (5/8) of patients achieved patent urethra and continence.

Conclusions: TRPA combined with incontinence surgery is a reasonable treatment for patients with recurrent VUAS. Nonetheless, this is a set of difficult surgeries that may ultimately end in failure, i.e. the inability to restore urethral patency, urinary incontinence or urinary diversion, hence they should be performed by experienced surgeons.

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How to Cite

Gwara, P., Białek, Łukasz, Rydzińska, M., Dobruch, J., & Skrzypczyk, M. A. (2024). Outcomes of transperineal reanastomosis as a salvage treatment for recurrent vesicourethral anastomosis stenosis after radical prostatectomy. Archivio Italiano Di Urologia E Andrologia, 96(4). https://doi.org/10.4081/aiua.2024.12829
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