High pressure balloon dilation for vesicourethral anastomotic strictures after radical prostatectomy

BACKGROUND Vesicourethral anastomotic stricture (VAS) is a rare but serious complication following radical prostatectomy (RP), and various types of managements for VAS have been proposed. We investigated the efficacy of transurethral balloon dilation in the management of VAS after RP. METHODS A total of 128 consecutive patients underwent open RP at our hospital between 2008 and 2013; of these, 10 patients (7.8%) developed VAS. Transurethral balloon dilation was performed in all 10 patients, using a high pressure balloon catheter under fluoroscopic and endoscopic guidance. Follow-up endoscopy was performed, and patients in whom the stricture had recurred underwent repeat dilation. We retrospectively evaluated the management of VAS and short-term efficacy of high pressure balloon dilation. RESULTS The mean time from RP to diagnosis of VAS was 9 months (2-40 months); eight patients (80%) were diagnosed within 6 months of RP. Balloon dilation of VAS was technically successful in all patients, and no perioperative complications were recorded. The median follow-up after balloon dilation was 24 months (7-67 months). There was no recurrence of VAS in eight patients (80%) after the first balloon dilation, and all patients were controlled within the twice. CONCLUSION High pressure balloon dilation is a highly effective and minimally invasive procedure for treating VAS.