Differences in Recurrence Rate andIncontinence after Endoscopic Treatment of Vesicourethral Stenosis and Bladder Neck Stenosis
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Differences in Recurrence Rate andIncontinence after Endoscopic Treatment of Vesicourethral Stenosis and Bladder Neck Stenosis. / Kranz, Jennifer; Reiss, Philipp C; Salomon, Georg; Steffens, Joachim; Fisch, Margit; Rosenbaum, Clemens M.
In: FRONT SURG, Vol. 4, 2017, p. 44.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Differences in Recurrence Rate andIncontinence after Endoscopic Treatment of Vesicourethral Stenosis and Bladder Neck Stenosis
AU - Kranz, Jennifer
AU - Reiss, Philipp C
AU - Salomon, Georg
AU - Steffens, Joachim
AU - Fisch, Margit
AU - Rosenbaum, Clemens M
PY - 2017
Y1 - 2017
N2 - OBJECTIVES: The objective of this study was to compare the recurrence rate andde novoincontinence after endoscopic treatment of vesicourethral stenosis (VUS) after radical prostatectomy (RP) and for bladder neck stenosis (BNS) after transurethral resection of the prostate (TURP).METHODS: Retrospective analysis of patients treated endoscopically for VUS after RP or for BNS after TURP at three German tertiary care centers between March 2009 and June 2016. Investigated endpoints were recurrence rate andde novoincontinence. Chi-squared tests andt-tests were used to model the differences between groups.RESULTS: A total of 147 patients underwent endoscopic therapy for VUS (59.2%) or BNS (40.8%). Mean age was 68.3 years (range 44-86), mean follow-up 27.1 months (1-98). Mean time to recurrence after initial therapy was 23.9 months (1-156), mean time to recurrence after prior endoscopic therapy for VUS or BNS was 12.0 months (1-159). Patients treated for VUS underwent significantly more often radiotherapy prior to endoscopic treatment (33.3 vs. 13.3%;p = 0.006) and the recurrence rate was significantly higher (59.8 vs. 41.7%;p = 0.031). The overall success rate of TUR for VUS was 40.2%, success rate of TUR for BNS was 58.3%. TUR for BNS is significantly more successful (p = 0.031). The mean number of TUR for BNS vs. TUR for VUS in successful cases was 1.5 vs. 1.8, which was not significantly different. The rate ofde novoincontinence was significantly higher in patients treated for VUS (13.8 vs. 1.7%;p = 0.011). After excluding those patients with radiotherapy prior to endoscopic treatment, the recurrence rate did not differ significantly between both groups (60.3% for VUS vs. 44.2% for BNS;p = 0.091), whereas the rate ofde novoincontinence (13.8 for VUS vs. 0% for BNS;p = 0.005) stayed significantly higher in patients treated for VUS.CONCLUSION: Most patients with BNS are successfully treated endoscopically. In patients with VUS, the success rate is lower. Both stenoses differ with respect tode novoincontinence. Patients must be counseled regarding the increased risk ofde novoincontinence after endoscopic treatment of VUS, independent of prior radiotherapy. Longer follow-up is warranted to address long-term outcomes.
AB - OBJECTIVES: The objective of this study was to compare the recurrence rate andde novoincontinence after endoscopic treatment of vesicourethral stenosis (VUS) after radical prostatectomy (RP) and for bladder neck stenosis (BNS) after transurethral resection of the prostate (TURP).METHODS: Retrospective analysis of patients treated endoscopically for VUS after RP or for BNS after TURP at three German tertiary care centers between March 2009 and June 2016. Investigated endpoints were recurrence rate andde novoincontinence. Chi-squared tests andt-tests were used to model the differences between groups.RESULTS: A total of 147 patients underwent endoscopic therapy for VUS (59.2%) or BNS (40.8%). Mean age was 68.3 years (range 44-86), mean follow-up 27.1 months (1-98). Mean time to recurrence after initial therapy was 23.9 months (1-156), mean time to recurrence after prior endoscopic therapy for VUS or BNS was 12.0 months (1-159). Patients treated for VUS underwent significantly more often radiotherapy prior to endoscopic treatment (33.3 vs. 13.3%;p = 0.006) and the recurrence rate was significantly higher (59.8 vs. 41.7%;p = 0.031). The overall success rate of TUR for VUS was 40.2%, success rate of TUR for BNS was 58.3%. TUR for BNS is significantly more successful (p = 0.031). The mean number of TUR for BNS vs. TUR for VUS in successful cases was 1.5 vs. 1.8, which was not significantly different. The rate ofde novoincontinence was significantly higher in patients treated for VUS (13.8 vs. 1.7%;p = 0.011). After excluding those patients with radiotherapy prior to endoscopic treatment, the recurrence rate did not differ significantly between both groups (60.3% for VUS vs. 44.2% for BNS;p = 0.091), whereas the rate ofde novoincontinence (13.8 for VUS vs. 0% for BNS;p = 0.005) stayed significantly higher in patients treated for VUS.CONCLUSION: Most patients with BNS are successfully treated endoscopically. In patients with VUS, the success rate is lower. Both stenoses differ with respect tode novoincontinence. Patients must be counseled regarding the increased risk ofde novoincontinence after endoscopic treatment of VUS, independent of prior radiotherapy. Longer follow-up is warranted to address long-term outcomes.
KW - Journal Article
U2 - 10.3389/fsurg.2017.00044
DO - 10.3389/fsurg.2017.00044
M3 - SCORING: Journal article
C2 - 28848735
VL - 4
SP - 44
JO - FRONT SURG
JF - FRONT SURG
SN - 2296-875X
ER -