Overview
Vesico-urethral anastomotic stenosis (VUAS) is a potential complication following prostatectomy 1. Endoscopic procedures are frequently utilized as the initial management strategy for this condition, although their definitive success rates have historically remained unclear 1.Management
Endoscopic Procedures: Endoscopic treatment for VUAS has a pooled success rate of 72.8% (95% CI 64.4%–79.9%) 1.
Adjusted Success Rates: When accounting for potential publication bias using trim-and-fill analysis, the corrected overall success rate is estimated at 62.9% (95% CI 53.6%–71.4%) 1.Special Populations
History of Radiotherapy: Prior radiotherapy is a significant negative predictor of success for endoscopic management of anastomotic stenosis (P = 0.012) 1.Key Recommendations
Endoscopic procedures should be considered a viable initial treatment option for vesico-urethral anastomotic stenosis following prostatectomy, with an expected success rate of approximately 63% to 73% 1. (Evidence: Strong)
Clinicians should identify a history of radiotherapy as a factor that significantly reduces the likelihood of successful endoscopic treatment for anastomotic stenosis 1. (Evidence: Strong)References
1 Delchet O, Nourredine M, González Serrano A, Morel-Journel N, Carnicelli D, Ruffion A et al.. Post-prostatectomy anastomotic stenosis: systematic review and meta-analysis of endoscopic treatment. BJU international 2024. link