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Nontraumatic posterior urethral stenosis
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文摘
Posterior urethral stenoses and contractures are complications after treatment of benign prostatic hyperplasia (BPH), localized prostate cancer (PCa), and orthotopic neobladder formation, compromising prognosis and functional outcomes.ObjectivesTo identify factors related to etiology, prevention and treatment of non-traumatic posterior urethral stenosis and contractures.Acquisition of evidenceReview of the published evidence related to posterior urethral stenosis and contractures after PCa treatment, BPH therapies and orthotopic neobladder formation. PubMed database search with English and Spanish papers considered. Cohort studies, case series, prospective and retrospective studies and review papers were included.Synthesis of evidencePosterior urethral stenoses and contractures are common, leading to significant morbidity. A worsening on voiding quality should rise some concerns. Careful surgical and/or radiotherapic techniques prevent their development. Endoscopic therapies are the initial approach, with complex urethroplasties often required. Subsequent urinary incontinence, the most important sequelae, may need artificial sphincters.ConclusionsNon-traumatic posterior urethral stenoses could be important complications, potentially compromising the outcomes of initial therapy. They could require complex surgeries leading to urinary incontinence.

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