Sclérose de l'anastomose urétrovésicale après prostatectomie totale pour cancer

The present paper intends to review diagnosis and treatment issues of bladder neck anastomosis stricture after radical prostatectomy for localised prostate cancer. Even though cancer control is not necessarily a concern, quality of life may be greatly altered. Patients may suffer from dysuria, urgency and the feeling of incomplete bladder emptying. Flowmetry, cystoscopy and cystography contribute to its diagnosis. Treatment should be graded according to the severity of the disease and the quality of life of the patient. Cold-Knife incisions and pneumatic dilatation are the first line treatments. Holmium laser shows good results on the stricture in a second line treatment. A two-stage strategy with an endoluminal stent followed by artificial urinary sphincter implant is the ultimate option to manage severe strictures, while maintaining acceptable quality of life. Continence sparing is the challenge of the treatment of this type of stricture.