Introduction: Vesicourethral anastomosis strictures (VUAS) after radical prostatectomy (RP) are the most common late complication along urinary incontinence. Presence of a stricture can be followed by urinary incontinence, although continent patients report stricture morbidity as well. Urinary continence is a decisive factor in the treatment algorithm. A sufficiently high percentage of VUAS and the negative affect on the life quality and social adaptation of the patient after radical prostatectomy determine the relevance of studying the effectiveness of various correction methods of this complication.
Materials and methods: A search was conducted in the databases Pubmed, Web of science, Cyberleninka, elibrary, TsNMB for the period from 1994 to 2019 for the following keywords: treatment of strictures of vesicourethral anastomosis, incision, bougieurage, endoscopic correction, laser ablation, plasma vaporization, robot-assisted reanastomosis, urethral plastic with a buccal flap.
Results: The data of 24 scientific articles are presented. The main methods of treatment of VCA, both minimally invasive and open, are highlighted, a description of their implementation technique and the results of a relapse-free course after treatment are given. At the moment, first step treatment is based on endoscopic procedures, which are reported to have high reliability, low invasiveness and are simple to perform, although use of open reconstructive surgery is required after several endoscopic failures. Also, drug injection and radioactive therapy are performed as additional support to surgical methods of treatment. A detailed study of all developed reconstructive treatment methods is necessary to design a generally accepted treatment plan taking into account the individual characteristics of each patient. Despite the absence of a fully recommended method for the treatment of VUAS, due to the development of plenty surgical technologies, a variety range of correction methods exists, which may lead to the invention of a united, most effective, method of treatment of this disease. This review contains information about the diagnostic plan, selection of treatment, description and results of various options on curing VUAS, taking into account recurrence rates and availabs4ility of equipment needed, as well as a presentation of experimental techniques.
Conflict of interest. The authors declare no conflict of interest.