Modified cystoscopy-assisted laparoscopic Y-V plasty for recalcitrant bladder neck contracture

Abstract

Background and aim

Recalcitrant bladder neck contracture (BNC) is a common complication after transurethral resection of the prostate. Our aim was to show the outcomes of a modified cystoscopy-assisted laparoscopic Y-V plasty for BNC treatments.

Material and methods

We retrospectively evaluated a series of 27 patients who underwent a modified cystoscopy-assisted laparoscopic Y-V plasty for recalcitrant BNC from January 2017 to September 2019. Urinary flow rate, international prostate symptom score (IPSS), international index of erectile function-5 (IIEF-5) and bladder urethral examination by cystoscopy were performed preoperatively and postoperatively, respectively.

Results

All patients underwent the procedure successfully and no serious complication occurred. The median surgery time was 68.6 min without massive bleeding. The median follow-up time was 14.2 months and no patients had urinary incontinence. The maximum urine flow rate 3 months after surgery was significantly higher than prior to surgery (17.7 ± 2.1 ml/s vs. 8.2 ± 1.2 ml/s, p < 0.05). The IPSS was significantly decreased compared with the preoperative score (5.7 ± 2.3 vs. 19.2 ± 1.4, p < 0.05). The cystoscopy showed a wide bladder neck and the survival bladder flap in prostate urethral 3 months postoperatively in 92.6% (25/27) patients.

Conclusions

The modified cystoscopy-assisted laparoscopic Y-V plasty is a feasible and effective technique for recalcitrant BNC treatment.

Keywords:

• Cystoscopy-assisted
• laparoscopic
• Y-V plasty
• bladder neck contracture

Ethical approval

The study protocol was approved by the Ethics Committees of Beijing Jishuitan Hospital (No. 20191223). Informed consent was obtained from all individual participants included in the study.

Acknowledgement

We thank the surgical staff and nursing team who were involved the care of patient.

Declaration of interest

The authors have no conflicts of interest to declare.