dc.creatorGómez, Reynaldo G.
dc.creatorValverde, Laura G.
dc.creatorCampos, Rodrigo A.
dc.creatorSaavedra, Álvaro A.
dc.creator Delgado, Erico J.
dc.creator Santucci, Richard A. 
dc.creator Scarberry, Kyle A.
dc.date.accessioned2020-11-10T13:53:48Z
dc.date.available2020-11-10T13:53:48Z
dc.date.created2020-11-10T13:53:48Z
dc.date.issued2020
dc.identifierWorld Journal of Urology Aug 2020
dc.identifier10.1007/s00345-020-03399-2
dc.identifierhttps://repositorio.uchile.cl/handle/2250/177629
dc.description.abstractPurpose Injury to the external sphincter during urethroplasty at or near the membranous urethra can result in incontinence in men whose internal sphincter mechanism has been compromised by previous benign prostatic hyperplasia (BPH) surgery. We present outcomes of a novel reconstructive procedure, incorporating a recent anatomic discovery revealing a connective tissue sheath between the external sphincter and membranous urethra, which provides a surgical plane allowing for intrasphincteric bulbo-prostatic urethroplasty (ISBPA) with continence preservation. Methods Stricture at or near the membranous urethra after transurethral resection (TURP) or open simple prostatectomy (OSP) was reconstructed with ISBPA. The bulbomembranous junction is approached dorsally with a bulbar artery sparing approach and the external sphincter muscle is carefully reflected, exposing the wall of the membranous urethra. Gentle blunt dissection along this connective tissue plane allows separating the muscle away up to the prostatic apex, where healthy urethra is found for anastomosis. Results From January 2010 to August 2019, 40 men (18 after TURP and 22 after OSP) underwent ISBPA at a single institution. Mean age was 67 years (54-82). Mean stricture length was 2.6 cm (1-6) with obliterative stricture identified in 10 (25%). At a mean follow-up of 53 months (10-122), 36 men (90%) are free of stricture recurrence and 34 (85%) were completely dry or using one security pad. Conclusion This novel intrasphincteric urethroplasty technique for stricture following BPH surgery is feasible and safe, allowing successful reconstruction with continence preservation in most patients. A larger series and reproduction in other centers is needed.
dc.languageen
dc.publisherSpringer
dc.rightshttp://creativecommons.org/licenses/by-nc-nd/3.0/cl/
dc.rightsAttribution-NonCommercial-NoDerivs 3.0 Chile
dc.sourceWorld Journal of Urology
dc.subject  Urethral stricture
dc.subjectUrinary incontinence
dc.subject Transurethral resection of prostate
dc.subjectUrethra
dc.titleIntrasphincteric anastomotic urethroplasty allows preservation of continence in men with bulbomembranous urethral strictures following benign prostatic hyperplasia surgery
dc.typeArtículo de revista


Este ítem pertenece a la siguiente institución