Bladder Neck Contracture After Radical Prostatectomy: What Is the Reality of Care?
Bladder Neck Contracture After Radical Prostatectomy: What Is the Reality of Care?
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DOI：
10.1089/end.2016.0509
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发表时间：
2017-01-01
影响因子：
2.7
通讯作者：
Wagener, Nina
中科院分区：
文献类型：
--
作者：
Pfalzgraf, Daniel;Siegel, Fabian P.;Wagener, Nina
目的：探讨前列腺癌根治术(RP)后膀胱颈痉挛(BNC)的治疗方法和算法。材料和方法：邀请德国泌尿外科学会(DGU)列出的170个德国泌尿外科科室的负责人参加一项基于互联网的个性化调查。问题包括流行病学部分(医院类型、执业状况)和使用外科技术的问题及其发生率和治疗算法。结果：在联系的170名德国泌尿外科主任中，84人回答了问卷，回收率为49.41%。最常见的治疗方法是经尿道电切术、冷刀切开、热刀切开和扩张术。在使用几种治疗方式的机构中，56(66.67%)遵循治疗算法，而28(33.33%)遵循不确定的治疗顺序。然而，在使用SET算法的56家机构中，确定了33种不同的方法。在84家机构中，29家(34.52%)在BNC复发的情况下进行开放再吻合，其余55家(65.48%)未进行再吻合。结论：尽管已发表了多份关于尿路狭窄的指南，但仍有许多自行使用的治疗算法用于治疗BNC。虽然这项工作不能确定这些算法的治疗结果和基本的治疗方式，但它突显了进一步研究比较不同手术的必要性，以便采取更循证的方法。
Objectives: To evaluate the therapeutic methods and algorithms currently used in the treatment of bladder neck contracture (BNC) after radical prostatectomy (RP).Materials and Methods: Heads of 170 urologic departments in Germany, listed at the German Society of Urology (DGU), were invited to participate in an Internet-based customized survey. The questions consisted of an epidemiologic part (kind of hospital, state of practice) and questions inquiring used surgical techniques with their respective incidence and given algorithms for therapy.Results: Of 170 contacted heads of urologic departments in Germany, 84 responded to the questionnaire (return rate 49.41%). The most common treatment modalities are transurethral resection, cold knife incision, hot knife incision, and dilation in descending order. For those institutions using several treatment modalities, 56 (66.67%) follow a therapeutic algorithm, while 28 (33.33%) follow no set order of treatment. However, among the 56 institutions with a set algorithm, 33 different approaches were identified. Of 84 institutions, 29 (34.52%) perform open reanastomosis in case of recurrent BNC, the remaining 55 (65.48%) do not.Conclusion: Despite several published guidelines on urethral strictures, numerous self-employed treatment algorithms are used to treat BNC. Although treatment results of these algorithms and the underlying treatment modalities cannot be determined with this work, it highlights the necessity for further studies comparing the different surgeries to allow for a more evidence-based approach.