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The T-plasty as therapy for recurrent bladder neck stenosis: success rate, functional outcome, and patient satisfaction

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Abstract

Purpose

To determine success rate (SR), functional outcome, and patient satisfaction of a modified YV-plasty for reconstruction of the bladder neck in case of recurrent bladder neck stenosis (BNS) after transurethral surgery of the prostate: the T-plasty.

Patients and methods

We identified all patients who underwent T-plasty at our center between December 2008 and July 2016. Patients’ charts were reviewed. Patients were queried by telephone and by mail at time of follow-up (FU). Primary endpoint was SR. Secondary endpoints were complications, continence, satisfaction, and changes in quality of life measured by validated questionnaires.

Results

Thirty patients underwent the T-plasty. Median age at surgery was 69 (IQR 62–73) years. Most patients had BNS due to TUR-P [n = 25 (83.3%)]. No severe blood loss or severe complications occurred perioperatively. Median FU was 45 (IQR 18–64) months. Three patients were lost to FU. Success rate was 100%. Compared to pre-OP Q max, mean Q max post-OP improved significantly [pre-OP 6.79 (SD ± 4.76) ml/s vs post-OP was 24.42 (SD ± 12.61) ml/s; (t(5) = 4.12, p = 0.009)]. Mean post-void residual urine decreased significantly [pre-OP 140.77 (SD ± 105.41) ml vs post-OP 14.5 (SD ± 22.42) ml; (t(9) = −3.86, p = 0.004)]. One patient developed a de-novo-incontinence post-OP. Mean ICIQ-SF Score was 1.2 (SD ± 2.27). 88.5% of patients were pleased or delighted by surgery. 75% of patients claimed their quality of life has been (strongly) improved.

Conclusions

The T-plasty is a valuable option as treatment of recurrent BNS. SR, rates of continence, and high patient satisfaction are very encouraging.

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Author notes

  1. Clemens M. Rosenbaum and Roland Dahlem have contributed equally.

Authors and Affiliations

  1. Department of Urology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany

    Clemens M. Rosenbaum, Roland Dahlem, Valentin Maurer, Luis A. Kluth, Malte W. Vetterlein, Margit Fisch, Victor Schuettfort & C. Philip Reiss

Authors
  1. Clemens M. Rosenbaum
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  2. Roland Dahlem
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  3. Valentin Maurer
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  4. Luis A. Kluth
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  5. Malte W. Vetterlein
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  6. Margit Fisch
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  7. Victor Schuettfort
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  8. C. Philip Reiss
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Contributions

CMR: protocol development, data collection and management, data analysis, and manuscript writing; RD: protocol development, data management, and manuscript editing; VM: data management and manuscript editing; LAK: protocol development and manuscript editing; MWV: manuscript editing; MF: protocol development and manuscript editing; VS: manuscript editing; CPR: protocol development and manuscript editing.

Corresponding author

Correspondence to Clemens M. Rosenbaum.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in this study were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Rosenbaum, C.M., Dahlem, R., Maurer, V. et al. The T-plasty as therapy for recurrent bladder neck stenosis: success rate, functional outcome, and patient satisfaction. World J Urol 35, 1907–1911 (2017). https://doi.org/10.1007/s00345-017-2089-2

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  • DOI: https://doi.org/10.1007/s00345-017-2089-2

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