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03.07.2017 | Original Article

Transperineal reanastomosis for treatment of highly recurrent anastomotic strictures after radical retropubic prostatectomy: extended follow-up

verfasst von: Victor Maximilian Schuettfort, Roland Dahlem, Luis Kluth, Daniel Pfalzgraf, Clemens Rosenbaum, Tim Ludwig, Margit Fisch, Christoph-Philip Reiss

Erschienen in: World Journal of Urology | Ausgabe 12/2017

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Abstract

Objectives

To re-evaluate safety and efficacy of transperineal reanastomosis (TPRA) as a viable therapeutic option in highly recurrent anastomotic strictures (AS) after radical retropubic prostatectomy (RRP).

Methods

Retrospective analysis by standardized questionnaire inquiring for recurrence of stricture, stress urinary incontinence (SUI), sexual function, satisfaction, and changes in quality of life (QoL) was performed in all patients undergoing TPRA. Validated questionnaires (ICIQ-UI, EQ-5D, and IPSS) were included.

Results

Median follow-up was 45.0 months. The average number of prior operations was 4.69. Success rate was 87% (20/23). Three recurrences were successfully treated via endoscopic means. All patients had urinary incontinence pre-op and post-op. Implantation of an artificial urinary sphincter (AUS) has been performed successfully in 73.9% (17/23). Rate of complications was low (8.7%; 2/23, Clavien–Dindo Grade II + III). EQ-5D-VAS showed a good general state of health (73.5/100). An improvement in QoL was noted in 63.6% (14/22) and patient satisfaction was high (72.7%; 16/22).

Conclusions

This extended follow-up confirms the initial results for TPRA as an excellent treatment option for highly recurrent AS after RRP. Postoperative SUI as a consequence of transsphincteric urethral mobilization can be satisfactorily treated by the implantation of AUS. In case of AS recalcitrant to endoscopic treatment, the described procedure—even though technically challenging—represents a valuable treatment option.

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Titel: Transperineal reanastomosis for treatment of highly recurrent anastomotic strictures after radical retropubic prostatectomy: extended follow-up
verfasst von: Victor Maximilian Schuettfort
Roland Dahlem
Luis Kluth
Daniel Pfalzgraf
Clemens Rosenbaum
Tim Ludwig
Margit Fisch
Christoph-Philip Reiss
Publikationsdatum: 03.07.2017
Verlag: Springer Berlin Heidelberg
Erschienen in: World Journal of Urology / Ausgabe 12/2017
Print ISSN: 0724-4983
Elektronische ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-017-2067-8

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Transperineal reanastomosis for treatment of highly recurrent anastomotic strictures after radical retropubic prostatectomy: extended follow-up

Abstract

Objectives

Methods

Results

Conclusions

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Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

Abstract

Objectives

Methods

Results

Conclusions

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