Holmium: YAG Laser Incision of Bladder Neck Contracture Following Radical Retropubic Prostatectomy

Abstract

Background: No consensus management is available for the bladder neck contracture (BNC) secondary to radical retropubic prostatectomy (RRP). We present our experience of a technique in which holmium: YAG surgical laser was utilized transurethrally to incise the stenotic area. Methods: Incisions with holmium: YAG surgical laser were made in 34 subjects with BNC between January 2012 and May 2018. Medical charts were reviewed to evaluate related data including medical history, international prostate symptoms score, uroflowmetry, and recurrence of the stricture. Results: The mean length of operation was 34 ± 4.06 minutes. No significant postoperative or perioperative complications were noted. The median length of hospital stay after surgery was two days. Five subjects (13.8%) required endoscopic holmium: YAG laser retreatment. After the first treatment with holmium: YAG surgical laser, the mean duration for recurrence was 4.3 months. In addition, significant improvements were observed in Qmax, residual urine volume, and the total IPSS score. Conclusions: BNC after RRP is relatively frequent but it can be safely and effectively managed by transurethral holmium: YAG laser incision