Holmio Laser treatment for bladder neck contractures (BNCs) in the prostate cancer survivor
Abstract
Thera are many treatment for bladder neck contractures (BNCs) in the prostate cancer survivor.BNC rates have decreased significantly in the last 2 decades, likely because of improvement in the surgical technique and increased utilization of laparoscopic and robotic surgery, which may allow better visualization of the vesicourethral anastomosis.
A number of therapeutic options are available, however. In the event of BNC development, treatment should be structured minimizes the risk of urinary incontinence
The results of minimally invasive procedures such as urethral dilation and transurethral incision of the bladder neck may be not sufficient to dominate this elusive confition.
Significant factors associated with treatment failure were >10 pack/year smoking history (P = .039) and ≥ 2 previous endoscopic BNC procedures (P = .03).
A total of 21 patients with postprostatectomy bladder neck contracture underwent treatment with Nd:YAG laser irradiation. A new 600-microns hemispherical optical quarz fiber was used in contact technique to produce linear incisions in the scarred tissue.
Overall success rate of 86% after 2 procedures.
Endoscopic application of laser energy in the contact mode enables the immediate vaporization and disintegration of the fibrous area and secondary reepithelization of the bladder neck without scarring.