Vesicourethral anastomotic strictures after radical prostatectomy: efficacy of transurethral balloon dilation.

Abstract

To assess the efficacy of transurethral balloon dilation of vesicourethral anastomotic strictures after radical retropubic prostatectomy. Forty-five consecutive patients in whom vesicourethral anastomotic strictures developed after radical prostatectomy underwent fluoroscopically guided transurethral balloon dilation (n = 27), cystoscopically guided transurethral incision of the bladder neck (n = 10), or dilation performed by urologists who used various techniques (n = 8). Transurethral balloon dilation was successful in 16 (59%) of 27 patients. Ten of the 11 patients who did not respond favorably underwent transurethral incision of the bladder neck. Seven (70%) of these patients required either repeat attempts or subsequent balloon dilation. New urinary incontinence developed in one patient treated primarily with transurethral incision of the bladder neck but in no patients treated with transurethral balloon dilation. Anastomotic strictures after radical prostatectomy can be effectively treated with transurethral balloon dilation with no serious complication. Refractoriness to balloon dilation may be related to the presence of dense scar tissue.