MP03-14 DURABLE TREATMENT OF REFRACTORY VESICOURETHRAL ANASTOMOTIC STENOSIS VIA ROBOTIC-ASSISTED RECONSTRUCTION: A TRAUMA AND UROLOGIC RECONSTRUCTIVE NETWORK OF SURGEONS STUDY

You have accessJournal of UrologyTrauma/Reconstruction/Diversion: Urethral Reconstruction (including Stricture, Diverticulum) I (MP03)1 Sep 2021MP03-14 DURABLE TREATMENT OF REFRACTORY VESICOURETHRAL ANASTOMOTIC STENOSIS VIA ROBOTIC-ASSISTED RECONSTRUCTION: A TRAUMA AND UROLOGIC RECONSTRUCTIVE NETWORK SURGEONS STUDY Nabeel Shakir, Nejd Alsikafi, Julia Buesser, Gregory Amend, Benjamin Breyer, Jill Buckley, Bradley Erickson, Joshua Broghammer, William Parker, and Lee Zhao ShakirNabeel Shakir More articles by this author , AlsikafiNejd Alsikafi BuesserJulia Buesser AmendGregory Amend BreyerBenjamin Breyer BuckleyJill Buckley EricksonBradley Erickson BroghammerJoshua Broghammer ParkerWilliam Parker ZhaoLee View All Author Informationhttps://doi.org/10.1097/JU.0000000000001964.14AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION OBJECTIVE: Refractory vesicourethral anastomotic stenosis (VUAS) post radical prostatectomy poses challenges distinct from bladder neck contracture (BNC), due its deep location in the pelvis, close sphincter mechanism. Open reconstruction is technically demanding, risking de novo stress urinary incontinence (SUI) or VUAS recurrence. Our multi-institutional group presents our experience with robotic-assisted reconstruction. METHODS: Patients who underwent 2015-2020 were identified. Patency was defined as either atraumatic passage a 17 French flexible cystoscope peak flow on uroflowmetry >15 mL/s. De SUI >1 pad per day need for operative intervention. RESULTS: total 32 patients 6 institutions met study criteria, whom 16 (50%) had history pelvic radiation. The median number prior endoscopic treatments 3 (interquartile range 2-3), 19 (59%) preexisting SUI. Intraoperatively, 15 (47%) obliterative VUAS, 11 (34%) spanned membranous urethra, (9%) synchronous urethral strictures. Operative management included redo anastomosis cases (47%), buccal mucosa graft augmentation (19%) (53%) anterior flap used. Median time 322 minutes (224-415) length hospital stay 1 (1-2). At follow up 12 months (7-18), 25 (78%) patent repairs 26 (81%) voiding urethra (Figure 1). Recurrent stenoses managed robotic (2/7), endoscopically (3/7), catheterization (2/7). Of 13 without SUI, (85%) continent at last follow-up. No diversion. CONCLUSIONS: Robotic assisted viable successful option refractory following prostatectomy. retropubic approach along technique demonstrated high patency continence rates. Source Funding: None © 2021 American Urological Association Education Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e26-e26 Advertisement Copyright & Permissions© Inc.MetricsAuthor Information Expand Loading ...