Burlington, MA—In patients with recurrent bladder neck contractures, history often repeats itself with multiple surgeries and poor outcomes, but reconstructive urologists are now hopeful they have a better solution.
In a retrospective study, surgeons from the Lahey Clinic in Burlington, MA, reported that a novel approach using radial urethrotomy with mitomycin C (MMC) injections led to a patent bladder neck in nearly three-fourths of patients after a single procedure and 81% after two procedures.
“For patients who have failed standard management of these challenging recurrent bladder neck contractures, they should be given the opportunity for this adjunctive agent to improve their outcome and need no further intervention,” study co-author Jill C. Buckley, MD, told Urology Times.
“Otherwise, we would be just continuing to do what had been done—more incisions, more dilations, more Foley-dependent patients,” said Dr. Buckley, a former Lahey Clinic faculty member who is currently associate professor of urology at the University of California, San Diego Health System.
The study, presented at the AUA annual meeting in Orlando, FL, is a follow-up to an initial pilot study by the Lahey group published 3 years ago in the Journal of Urology (2011; 186:156-60). AUA attendees urged the researchers to conduct a prospective, randomized study and raised concerns about possible adverse events.
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