Effectiveness of contemporary treatments for iatrogenic urethral strictures following endoscopic management of benign prostatic hyperplasia: a comprehensive review
Rattachement africain : it, us, pl, de, fr, ie, ar, gb, be. Niveau de preuve : code pays fourni par la source.
Le résumé fourni par la source
PURPOSE: Iatrogenic urethral strictures represent a relevant complication following endoscopic surgical treatment for benign prostatic hyperplasia, potentially leading to significant morbidity and impaired quality of life. Despite advances in endoscopic technologies, urethral trauma related to prolonged operative time and large-caliber instruments remains a concern. The optimal management of urethral strictures secondary to surgery is still debated, and high-quality evidence comparing endoscopic and open reconstructive approaches is lacking. This systematic review aimed to evaluate the efficacy and safety of contemporary treatments for iatrogenic urethral strictures following endoscopic management of benign prostatic hyperplasia. MATERIALS AND METHODS: A systematic review was conducted according to PRISMA guidelines and registered in PROSPERO (CRD42024604611). MEDLINE, Embase, and the Cochrane Library were searched from 2000 to June 2025. Studies reporting outcomes of endoscopic or open surgical treatments for urethral strictures following benign prostatic hyperplasia surgery were included. Data extraction focused on patient characteristics, stricture features, treatment modality, success rates, complications, and follow-up. Due to substantial heterogeneity, a meta-analysis was not performed. RESULTS: Eleven studies comprising a total of 610 patients were included. Of these, 443 (73%) patients underwent primary treatment for urethral stricture, while 167 (27%) were treated for recurrent disease. The bulbar and membranous urethra were the most commonly involved sites. Overall, 58 patients (9%) underwent endoscopic management, whereas 552 patients (91%) were treated with open reconstructive surgery. The overall recurrence rate was 8 and 10% for both endoscopic and open approaches. However, follow-up duration differed substantially between groups, ranging from 12 to 24 months in endoscopic series and extending up to 54 months in open reconstructive cohorts. Complication rates were generally low. No perioperative or functional complications were reported following endoscopic treatments. Among open procedures, urinary incontinence was the most frequent complication, with rates varying from 4% after ventral onlay graft urethroplasty to 15% following intrasphincteric bulbo-prostatic anastomosis. Flap-related complications were rare. CONCLUSION: Management of urethral strictures following endoscopic prostatic surgery remains challenging. While endoscopic treatments offer acceptable short-term outcomes with minimal morbidity, open reconstructive surgery provides more durable long-term results at the cost of a higher, yet acceptable, risk of functional complications. Treatment choice should be individualized based on stricture characteristics, patient factors, and surgical expertise. Prospective, multicenter studies with standardized outcome reporting and longer follow-up are warranted to optimize treatment algorithms for this complex condition.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Effectiveness of contemporary treatments for iatrogenic urethral strictures following endoscopic management of benign prostatic hyperplasia: a comprehensive review
- Date Crossref
- 21/05/2026
- Éditeur
- Springer Science and Business Media LLC
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Azienda Ospedaliero-Universitaria Careggi pays non établi dans la noticeÉtablissement de santé
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University of Florence Department of Experimental and Clinical Medicine pays non établi dans la noticeUniversité ou école supérieure
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University of California Department of Urology pays non établi dans la noticeUniversité ou école supérieure
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Postgraduate School of Molecular Medicine pays non établi dans la noticeStructure de recherche
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AOL (United States) pays non établi dans la noticeEntreprise
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Gdańsk Medical University pays non établi dans la noticeUniversité ou école supérieure
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Klinikum Leverkusen pays non établi dans la noticeÉtablissement de santé
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Universität Hamburg pays non établi dans la noticeUniversité ou école supérieure
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University Medical Center Hamburg-Eppendorf Department of Urology pays non établi dans la noticeÉtablissement de santé
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University of Genoa Department of Surgical and Diagnostic Integrated Sciences (DISC) pays non établi dans la noticeUniversité ou école supérieure
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Hospices Civils de Lyon pays non établi dans la noticeÉtablissement de santé
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Policlinico Umberto I pays non établi dans la noticeÉtablissement de santé
Azienda Ospedaliero-Universitaria Careggi, Department of Experimental and Clinical Medicine — University of Florence et Department of Urology — University of California, avec 9 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.