Transurethral resection and buccal mucosal graft for the treatment of refractory bladder neck contracture


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Abstract

Bladder neck contracture after prostate surgery is a rare but feared complication. The treatment of choice is endoscopic incision or resection of fibrotic tissue. In case of ineffective transurethral correction, bladder neck reconstruction has to be done. In this report, we present a complicated case treated with combined transurethral and laparoscopic bladder neck reconstruction with buccal mucosal graft inlay. Using retrograde endoscopy fibrotic tissue in the bladder neck was resected to achieve a smooth and wide prostate cavity. After that the laparoscopy performed. The retropubic space is created and prostatic urethra opened via longitudinal prostatic-vesical incision. Buccal mucosal graft was fixed in place. Bladder and prostatic urethra were closed with resorbable suture. Two weeks after surgery the urethral catheter was removed and adequate voiding reestablished. After eleven months patient had no urination complaints and any sings of recurrence. Thus, the combined surgical approach for bladder neck reconstruction using buccal mucosa inlay may be a durable option for treatment of recalcitrant bladder neck contracture.

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About the authors

I. E Mamaev

Pirogov Russian National Research Medical University, Ministry of Healthcare of Russia; State budgetary healthcare institution “Moscow City Clinical Hospital n.a. V.M. Buyanov”

Email: dr.mamaev@mail.ru
Cand.Med.Sci., head of urology department of Moscow city hospital n.a. V.M.Buyanov, assistant professor of the urology department of Pirogov Russian National Research Medical University

K. K Akhmedov

State budgetary healthcare institution “Moscow City Clinical Hospital n.a. V.M. Buyanov”

Email: k.k.akhmedov@gmail.com
urologist at the urology department

A. D Bolotov

Pirogov Russian National Research Medical University, Ministry of Healthcare of Russia

Email: adbolotov@gmail.com
Cand.Med.Sci. assistant at the department of urology and andrology

A. G Yusufov

Pirogov Russian National Research Medical University, Ministry of Healthcare of Russia

Email: anvar.yusufov@mail.ru
Cand.Med.Sci. assistant at the department of urology and andrology

S. V Kotov

Pirogov Russian National Research Medical University, Ministry of Healthcare of Russia

Email: urokotov@yandex.ru
Dr.Med.Sc., professor, head of the the urology and andrology department

References

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