Diagnosis and management of the strictures after prostatectomy

Late postoperative period (> 4-6 weeks) complications of prostatectomies ( open, TURP) done for BPH include urethral stricture and bladder neck contracture. Stricture rate, which used to be % 429, is reduced to 2.2-9.8% nowadays by means of improvements in surgical instruments and techniques. Factors held responsible for development of urethral strictures include large prostate volume, prolonged operation time, size and material of catheter, urinary tract infection, usage of thick shaft and high energy, energy leakage from shaft. Strictures are diagnosed by endoscopy and imaging modalities. Besides frequently used classical treatment options like urethral dilatation and internal urethrotomy, there are some options like systemic or local application of certain antiinflammatory agents and urethroplasty. Avoid of over resection bladder neck, usage of appropriate generators, periodical maintenance of devices, early establishing of potential energy leakage points on the shaft, and usage of sufficient lubricating materials can reduce these complications.