Robot-assisted T-plasty for recalcitrant bladder neck stenosis: description of technique and initial results.

IF 4.9 2区 医学 Q1 UROLOGY & NEPHROLOGY Minerva Urology and Nephrology Pub Date : 2024-10-09 DOI:10.23736/S2724-6051.24.05872-5
Nicolaas Lumen, Zeyu Wang, Mieke Waterschoot, Thomas Tailly, Beatrice Turchi, Wesley Verla
{"title":"Robot-assisted T-plasty for recalcitrant bladder neck stenosis: description of technique and initial results.","authors":"Nicolaas Lumen, Zeyu Wang, Mieke Waterschoot, Thomas Tailly, Beatrice Turchi, Wesley Verla","doi":"10.23736/S2724-6051.24.05872-5","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The aim of this study was to describe the technique and initial outcomes of robot-assisted T-plasty for recalcitrant bladder neck stenosis.</p><p><strong>Methods: </strong>Patients who underwent robot-assisted T-plasty for recalcitrant bladder neck stenosis in a single center were included. Presence of bladder neck stenosis was preoperatively confirmed by the combination of retrograde urethrography with voiding cysto-urethrography and flexible urethroscopy. Follow-up visits were performed with history taking, uroflowmetry and echographic residual urine measurement. Complications were graded according to the Clavien-Dindo classification. Patients without urinary symptoms and with a maximum uroflow of no less than 15mL/s were considered as successfully treated. Otherwise, cystoscopy would be performed, and recurrence was defined as the inability to pass a 14 French cystoscope through the bladder neck.</p><p><strong>Results: </strong>Since 2018, seven patients were treated. The etiologies were transurethral resection of the prostate and simple prostatectomy in respectively 6 patients and 1 patient. Cystoscopy was able to diagnose bladder neck stenosis in all cases whereas urethrography was equivocal in 3 out of 7 cases. Median (range) age at surgery was 60 (54-75) years, and median number of prior endoscopic treatment for bladder neck stenosis was 3 (1-16). The median operative time was 123 (110-159) minutes. No intraoperative complications were reported. Three patients suffered a grade 2 complication. After a median follow-up of 27 (4-74) months, the recurrence-free rate was 100% with no evidence of de-novo incontinence or erectile dysfunction.</p><p><strong>Conclusions: </strong>In our series, robot-assisted T-plasty suggests positive and safe outcomes in treating recalcitrant bladder neck stenosis with a good patency rate and low incontinence rate. Additionally, cystoscopy is reliable in the diagnosis of patients with inconclusive urethrography results.</p>","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":4.9000,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Minerva Urology and Nephrology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.23736/S2724-6051.24.05872-5","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"UROLOGY & NEPHROLOGY","Score":null,"Total":0}
引用次数: 0

Abstract

Background: The aim of this study was to describe the technique and initial outcomes of robot-assisted T-plasty for recalcitrant bladder neck stenosis.

Methods: Patients who underwent robot-assisted T-plasty for recalcitrant bladder neck stenosis in a single center were included. Presence of bladder neck stenosis was preoperatively confirmed by the combination of retrograde urethrography with voiding cysto-urethrography and flexible urethroscopy. Follow-up visits were performed with history taking, uroflowmetry and echographic residual urine measurement. Complications were graded according to the Clavien-Dindo classification. Patients without urinary symptoms and with a maximum uroflow of no less than 15mL/s were considered as successfully treated. Otherwise, cystoscopy would be performed, and recurrence was defined as the inability to pass a 14 French cystoscope through the bladder neck.

Results: Since 2018, seven patients were treated. The etiologies were transurethral resection of the prostate and simple prostatectomy in respectively 6 patients and 1 patient. Cystoscopy was able to diagnose bladder neck stenosis in all cases whereas urethrography was equivocal in 3 out of 7 cases. Median (range) age at surgery was 60 (54-75) years, and median number of prior endoscopic treatment for bladder neck stenosis was 3 (1-16). The median operative time was 123 (110-159) minutes. No intraoperative complications were reported. Three patients suffered a grade 2 complication. After a median follow-up of 27 (4-74) months, the recurrence-free rate was 100% with no evidence of de-novo incontinence or erectile dysfunction.

Conclusions: In our series, robot-assisted T-plasty suggests positive and safe outcomes in treating recalcitrant bladder neck stenosis with a good patency rate and low incontinence rate. Additionally, cystoscopy is reliable in the diagnosis of patients with inconclusive urethrography results.

查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
机器人辅助 T 形成形术治疗顽固性膀胱颈狭窄:技术描述和初步结果。
背景:本研究旨在描述机器人辅助膀胱颈狭窄T成形术的技术和初步结果:本研究旨在描述机器人辅助T成形术治疗顽固性膀胱颈狭窄的技术和初步疗效:方法:纳入在一个中心接受机器人辅助 T 形成形术治疗顽固性膀胱颈狭窄的患者。术前通过逆行尿道造影、排尿膀胱造影和柔性尿道镜检查确认是否存在膀胱颈狭窄。随访包括病史采集、尿流率测定和超声残余尿测定。并发症根据克拉维恩-丁多分类法进行分级。无排尿症状且最大尿流不低于 15 毫升/秒的患者被视为治疗成功。否则将进行膀胱镜检查,复发的定义是无法将14法分膀胱镜通过膀胱颈:自 2018 年以来,共有 7 名患者接受了治疗。病因分别为经尿道前列腺切除术和单纯前列腺切除术的患者分别为 6 人和 1 人。膀胱镜检查能够诊断出所有病例的膀胱颈狭窄,而尿道造影在 7 例病例中有 3 例诊断不明确。手术时的中位年龄(范围)为60(54-75)岁,之前接受过膀胱颈狭窄内镜治疗的中位数为3(1-16)次。手术时间中位数为123(110-159)分钟。无术中并发症报告。三名患者出现了二级并发症。中位随访27(4-74)个月后,无复发率为100%,且无证据显示再次出现尿失禁或勃起功能障碍:在我们的系列研究中,机器人辅助 T 形成形术在治疗顽固性膀胱颈狭窄方面具有积极而安全的效果,通畅率高,尿失禁率低。此外,对于尿道造影结果不确定的患者,膀胱镜检查也是可靠的诊断方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 去求助
来源期刊
Minerva Urology and Nephrology
Minerva Urology and Nephrology UROLOGY & NEPHROLOGY-
CiteScore
8.50
自引率
32.70%
发文量
237
期刊最新文献
Modified robot-assisted laparoscopic dismembered pyeloplasty for adult patients with horseshoe kidney: techniques and medium-term outcomes. Partial penectomy with reconstruction using a split-thickness skin graft: a multicenter experience. Robot-assisted retroperitoneoscopic kidney surgery with Versius®. The association between MET c.3328G>A p.Val1110Ile mutation and renal cell carcinomas in a specific population: data on histology, focality, onset and the need for surgery from a monocentric study. Augmentation cystoplasty in children with neuropathic bladder: long-term outcomes after 30 years experience.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1