Mp75-15 Time From Surgery for Benign Prostatic Enlargement to Symptoms of Obstruction Due to the Onset of Bladder Neck Stenosis Is Associated With Outcomes After Bladder Neck Incision

You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Non-neurogenic Voiding Dysfunction (Excluding OAB) (MP75)1 May 2024MP75-15 TIME FROM SURGERY FOR BENIGN PROSTATIC ENLARGEMENT TO SYMPTOMS OF OBSTRUCTION DUE TO THE ONSET OF BLADDER NECK STENOSIS IS ASSOCIATED WITH OUTCOMES AFTER BLADDER NECK INCISION Leonardo Quarta, Marco Bandini, Paolo Zaurito, Francesco Cattafi, Christian Corsini, Donato Cannoletta, Alfonso Santangelo, Andrea Cosenza, Michele Brancaccio, Nicole Albanese, Vincenzo Scattoni, Roberto Bertini, Renzo Colombo, Rayan Matloob, Umberto Capitanio, Giorgio Gandaglia, Andrea Salonia, Alberto Briganti, and Francesco Montorsi Leonardo QuartaLeonardo Quarta , Marco BandiniMarco Bandini , Paolo ZauritoPaolo Zaurito , Francesco CattafiFrancesco Cattafi , Christian CorsiniChristian Corsini , Donato CannolettaDonato Cannoletta , Alfonso SantangeloAlfonso Santangelo , Andrea CosenzaAndrea Cosenza , Michele BrancaccioMichele Brancaccio , Nicole AlbaneseNicole Albanese , Vincenzo ScattoniVincenzo Scattoni , Roberto BertiniRoberto Bertini , Renzo ColomboRenzo Colombo , Rayan MatloobRayan Matloob , Umberto CapitanioUmberto Capitanio , Giorgio GandagliaGiorgio Gandaglia , Andrea SaloniaAndrea Salonia , Alberto BrigantiAlberto Briganti , and Francesco MontorsiFrancesco Montorsi View All Author Informationhttps://doi.org/10.1097/01.JU.0001008676.21744.5f.15AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Bladder neck stenosis (BNS) is a known complication following surgery for lower urinary tract symptoms due to benign prostatic enlargement (BPE). While endoscopic bladder neck incision (BNI) is considered a viable treatment option, factors leading to success or failure remain not clearly elucidated. METHODS: This was a retrospective observational study which included patients receiving BNI for BNS after BPE surgery at our Institution between July 2014 and May 2023. International Prostate Symptoms Score (IPSS) was assessed three months after BNI. Failure after BNI was defined as IPSS score between 8-35pts. Logistic regression analysis assessed the association between treatment failure and predicting factors such as age, Charlson comorbidity index (CCI), technique of BNI (ho-laser vs. Collins knife vs. cold knife), time from BPE surgery to the onset on BNS symptoms (<6 vs. ≥6 months), number of BNI procedures (fist-time vs. redo), prostate volume at BPE surgery, hypertension, chronic kidney disease, peripheral arterial disease, and ischemic heart disease. RESULTS: We identified 110 consecutive patients receiving BNI. The majority (92.7%) received ho-laser BNI, while 3 and 5 received Collins and cold knife BNI, respectively. BPE surgery was performed using techniques such as HoLEP, TURP, and others (ThuVAP and suprapubic transvesical prostatectomy) in 64 (58.2%), 40 (36.4%), and 6 (5.5%) patients, respectively. Median time from BPE surgery to BNS symptoms was 13months (IQR: 6-36m). Overall, at the 3-month follow-up date, 48 (64%), 23 (30.7%), and 4 (5.3%) patients reported mild (0-7pts), moderate (8-19pts), and severe (20-35pts) symptoms according to IPSS, respectively. Time from BPE surgery to BNS symptoms <6 months was the only statistically significant risk factor associated with risk of BNI failure at uni and multivariable analyses (OR 0.17, 95%CI 0.03-0.83, p=0.039). Among patients reporting severe postoperative IPSS (4 men) after BNI, all presented one or multiple comorbidities, and one had a CCI of 3. Two of them presented BNS symptoms within 5 months after BPE surgery, one received three BNI treatments, and all had indwelling catheter at the time of BPE surgery. CONCLUSIONS: BNI is a reliable surgical option in patients with BNS after BPE surgery. It is associated with satisfactory outcomes which are not influenced by age, comorbidities, surgical technique for BPE surgery and type of surgical BNI. The time interval between BPE surgery and BNS symptoms appears to be the sole predictive factor for the success of BNI. Among patients reporting severe postoperative IPSS after BNI, all had indwelling catheter at the time of their BPE surgery, and each of them presented at least one comorbidity. When providing counseling to patients for BNI, it's important to take these factors into account. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e1238 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Leonardo Quarta More articles by this author Marco Bandini More articles by this author Paolo Zaurito More articles by this author Francesco Cattafi More articles by this author Christian Corsini More articles by this author Donato Cannoletta More articles by this author Alfonso Santangelo More articles by this author Andrea Cosenza More articles by this author Michele Brancaccio More articles by this author Nicole Albanese More articles by this author Vincenzo Scattoni More articles by this author Roberto Bertini More articles by this author Renzo Colombo More articles by this author Rayan Matloob More articles by this author Umberto Capitanio More articles by this author Giorgio Gandaglia More articles by this author Andrea Salonia More articles by this author Alberto Briganti More articles by this author Francesco Montorsi More articles by this author Expand All Advertisement PDF downloadLoading ...