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根治性前列腺切除术后难治性膀胱颈挛缩(BNC):患病率、影响及管理挑战

Refractory Bladder Neck Contracture (BNC) After Radical Prostatectomy: Prevalence, Impact and Management Challenges.

作者信息

Uguzova Sabine, Beisland Christian, Honoré Alfred, Juliebø-Jones Patrick

机构信息

Department of Urology, Stepping Hill Hospital, Manchester, UK.

Department of Urology, Haukeland University Hospital, Bergen, Norway.

出版信息

Res Rep Urol. 2023 Nov 7;15:495-507. doi: 10.2147/RRU.S350777. eCollection 2023.

Abstract

Bladder neck contracture is a recognised complication associated with radical prostatectomy. The management can be challenging, especially when refractory to initial intervention strategies. For the patient, the burden of disease is high and continence status cannot be overlooked. This review serves to provide an overview of the management of this recognised clinical pathology. Consideration needs to be given to minimally invasive approaches such as endoscopic incision, injectables, implantable devices as well as major reconstructive surgery where the condition persists. For the latter, this can involve open and robotic surgery as well as use of grafts and artificial sphincter surgery. These elements underline the need for a tailored and a patient centred approach.

摘要

膀胱颈挛缩是根治性前列腺切除术后公认的并发症。其治疗可能具有挑战性,尤其是在对初始干预策略无效时。对患者而言,疾病负担较重,控尿状况不容忽视。本综述旨在概述这种公认临床病理的治疗方法。对于持续存在该病症的情况,需要考虑采用微创方法,如内镜下切开、注射治疗、植入式装置,以及大型重建手术。对于后者,可能涉及开放手术和机器人手术,以及使用移植物和人工括约肌手术。这些因素凸显了采取个性化和以患者为中心的治疗方法的必要性。

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