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Bladder neck sclerosis: alternative methods of treatment and prospects for their development DOI: 10.29188/2222-8543-2021-14-3-94-99
- Abbosov Sh.A. – urologist, graduate student, Department of Urology and Andrology, Faculty of Fundamental Medicine, Lomonosov Moscow State University; Moscow, Russia; https://orcid.org/0000-0002-6212-3693
- Sorokin N.I. – Dr. Sc., professor, head of the urological service of the Medical Research and Edu-cation Center, Lomonosov Moscow State University, leading researcher in the Department of Urology and Andrology, Faculty of Fundamental Medicine, Lomonosov Moscow State University; Moscow, Russia; https://orcid.org/0000-0001-9466-7567
- Kadrev A.V. – PhD, Head of Ultrasound Diagnostics Department; Researcher, Department of Urology and Andrology, Medical Research and Education Center of Lomonosov Moscow State University; Assistant Professor, Diagnostic Ultrasound Division, Russian Medical Academy of Continuous Professional Education; Moscow, Russia; https://orcid.org/0000-0002-6375-8164
- Shomarufov A.B. – urologist, graduate student, Department of Urology and Andrology, Faculty of Fundamental Medicine, Lomonosov Moscow State University; Moscow, Russia; https://orcid.org/0000-0001-9271-0808
- Strigunov A.A. – urologist, graduate student Department of Urology and Andrology, Faculty of Fundamental Medicine, Lomonosov Moscow State University; Moscow, Russia; https://orcid.org/0000-0003-4518-634X
- Kabanova O.O. – 6th year student of the Faculty of Fundamental Medicine Lomonosov Moscow State University; Moscow, Russia; https://orcid.org/0000-0003-2936-0571
- Nesterova O.Yu. – resident physician at the Department of Urology and Andrology of the Faculty of Fundamental Medicine Lomonosov Moscow State University; Moscow, Russia; https://orcid.org/0000-0003-3355-4547
- Shaparov B.M. – urologist, graduate student, Department of Urology and Andrology, Faculty of Fundamental Medicine, Lomonosov Moscow State University; Moscow, Russia; https://orcid.org/0000-0002-0232-1567
- Kamalov A.A. – Academician of the Russian Academy of Sciences, Professor, Dr. Sc., Head of the Department of Urology and Andrology, Faculty of Fundamental Medicine, Lomonosov Moscow State University, Director of the Medical Research and Education Center of Lomonosov Moscow State University; Moscow, Russia; https://orcid.org/0000-0003-4251-7545
722 Introduction. Bladder neck sclerosis (BNS) is a widespread complication of the surgical treatment of prostate diseases. Nevertheless, the etiology and pathogenesis of BNC development are not well understood, the frequency and degree of iatrogenic BNS varies depending on what treatment took place before its appearance. Treatment options for BNS can vary from simple dilatation to complex surgical interventions. Clinical variants of BNS, as well as their treatment options, vary in complexity, from simple short annular contractures to obliterating stenosis, which requires a significant expansion of surgical treatment volume.
The purpose of this study – is to assess the effectiveness of modern and alternative methods of prevention and treatment of BNS based on the analysis of published studies.
Materials and methods. The search and analysis of publications in the databases PubMed, Scopus, Cochrane Library, elibrary, according to the keywords, «bladder neck sclerosis», «benign prostatic hyperplasia», «bladder neck contracture», «bladder neck stenosis», «balloon dilatation», «treatment». As a result, 46 publications were selected and included in this review.
Results and discussion. In this review, we highlighted the routine and alternative methods of BNS treatment. Currently, there are quite modern methods for treating prostate diseases (using robotic techniques, electrosurgical resections, and enucleations, laser enucleations, etc.), which are often complicated by secondary BNS. Nowadays, there are a lot of routine and alternative methods of treatment of secondary BNS in the urologist’s armamentarium. Routine methods include TUR and incision of the bladder neck using electric and laser energy, alternative methods include balloon dilatation, installation of a urethral stent, instillation (or intraoperative injection) of the bladder with cytostatics, hormonal drugs, derivatives of hyaluronic acid, and biomedical cell products.
Conclusions. According to the literature from the listed alternative treatment methods for BNS, balloon dilatation is the most promising one. Based on the results of the literature analysis, we concluded that the use of balloon dilatation as a method of primary (least invasive) treatment and prevention of the occurrence of BNS is advisable.
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