Rocco Nicholas R, Zuckerman Jack M
Naval Medical Center San Diego, San Diego, CA, USA.
Naval Medical Center San Diego, 34800 Bob Wilson Drive, San Diego, CA 92134, USA.
Ther Adv Urol. 2017 Apr 11;9(5):99-110. doi: 10.1177/1756287217701391. eCollection 2017 Oct.
Postprostatectomy vesicourethral anastomotic stenosis (VUAS) remains a challenging problem for both patient and urologist. Improved surgical techniques and perioperative identification and treatment of risk factors has led to a decline over the last several decades. High-level evidence to guide management is lacking, primarily relying on small retrospective studies and expert opinion. Endourologic therapies, including dilation and transurethral incision or resection with or without adjunct injection of scar modulators is considered first-line management. Recalcitrant VUAS requires surgical reconstruction of the vesicourethral anastomosis, and in poor surgical candidates, a chronic indwelling catheter or urinary diversion may be the only option. This review provides an update in the diagnosis and management of postprostatectomy VUAS.
前列腺切除术后膀胱尿道吻合口狭窄（VUAS）对患者和泌尿外科医生来说仍然是一个具有挑战性的问题。在过去几十年中，手术技术的改进以及围手术期对危险因素的识别和治疗已导致该疾病发生率有所下降。目前缺乏指导治疗的高级别证据，主要依赖于小型回顾性研究和专家意见。腔内泌尿外科治疗，包括扩张、经尿道切开或切除，无论是否辅助注射瘢痕调节剂，都被视为一线治疗方法。顽固性VUAS需要对膀胱尿道吻合口进行手术重建，而对于手术条件较差的患者，长期留置导尿管或尿流改道可能是唯一的选择。本综述提供了前列腺切除术后VUAS诊断和治疗的最新进展。
