Bladder neck stenosis after surgical treatment of patients with benign prostatic hyperplasia. Epidemiology. Modern treatment options

Abstract

Introduction. With the development of modern technologies and treatment methods of benign prostatic hyperplasia (BPH), there is an increase in the number of operations performed for this disease. In this regard, the absolute number of complications is also growing. Bladder neck stenosis (BNS) is one of those complications. The purpose of this review is to update information about currently available methods of treatment of BNS and their effectiveness. Materials and methods. 352 articles from the PubMed database, the scientific electronic library elibrary.ru and the websites of professional urological associations were analyzed. After processing the data, 37 articles and one practical guide were selected for the review. Results. Chronic diseases that contribute to the violation of microcirculation in the area of bladder neck (BN) (diabetes mellitus, atherosclerosis), smoking are predisposing factors for the development of BNS. A small volume of the prostate (less than 30 ml) is an independent risk factor and requires special attention when choosing a treatment method for patients with BPH. The amount of thermal exposure to the BN area during surgery affects the degree of microcirculation disturbance and, accordingly, the risk of BNS. Endoscopic methods of correction of BNS have moderate effectiveness in its primary occurrence and low effectiveness in recurrent cases. Reconstructive methods of correction of BNS shown to be highly effective in recurrent cases. Conclusion. Etiopathogenesis of BNS is multifactorial and depends on endogenous and exogenous factors. Treatment options for BNS range from simple outpatient procedures to complex reconstructive interventions. Each of the treatment methods should be considered individually for each patient, taking into account the characteristics of the patient’s history.