Laparoscopic bladder neck reconstruction techniques in recalcitrant sclerosis of the bladder neck after radical prostatectomy

Abstract

The term posterior urethral stricture is typically used to describe any pathological stricture whose anatomic origin is from the bladder neck to the distal end of the membranous urethra (1). Now located in this anatomical segment of the urethra, we can clearly define two basic nomenclature terms for a correct communication and evaluation of the text. Vesicourethral anastomosis stenosis (VUAS) is defined by a reduction in caliber at the level of the surgical junction of the bladder neck with the membranous urethra after radical prostatectomy (RP) in any of its surgical modalities. A minimum urethral caliber below which we will consider VUAS has not been defined. Usually, the method for classifying a VUAS is the impossibility of opening it with a 15 or 17 Fr cystoscope. The lack of uniformity in the diagnostic methods is evident in the wide range of reported incidences and the different percentages of success obtained with the proposed treatments (7,11–15). In contrast, the term bladder neck contracture (BNC) specifically refers to stricture of the proximal urethral junction and bladder neck with the prostate in situ; produced for example after a transurethral resection of the prostate (TURP), photo-vaporization of the prostate (PVP), or after radiation therapy for prostate cancer (2).