JCU - January 2022 - 46

961901
URO
Journal of Clinical UrologyYao et al.
Case Series
Incorporating intra-lesional injection
of mitomycin C in the management
algorithm for bladder neck
contractures and vesicourethral
anastomotic strictures
Henry H Yao1,2 , Shomik Sengupta2
and Justin Chee1,2,3
Journal of Clinical Urology
2022, Vol. 15(1) 46 -53
© British Association of
Urological Surgeons 2020
Article reuse guidelines:
sagepub.com/journals-permissions
DOI: 10.1177/2051415820961901
journals.sagepub.com/home/uro
https://doi.org/10.1177/2051415820961901
Abstract
Objective: This study aims to describe the experience of a single-surgeon series with the use of intra-lesional mitomycin
C (MMC) in the treatment of bladder neck contracture (BNC) and vesicourethral anastomotic stenosis (VUAS).
Patients and methods: From July 2014 to January 2019, patients who underwent bladder neck incision (BNI) and intralesional
MMC injection performed by a single surgeon were included in this retrospective study. Clinico-pathological
data were extracted from medical records. The primary outcome was recurrence rate following BNI and MMC injection.
Results: Ten patients were included in the study. The median age was 68 years. The cause of BNC or VUAS was
secondary to radical prostatectomy in eight patients and to endoscopic prostatectomy in two patients. The median
follow-up was 16.4 months. The success rate was 70% after first treatment with BNI and MMC injection, and 80% after
repeated treatment. There were no serious adverse events or complications related to the MMC injection.
Conclusion: BNI and intra-lesional MMC injection is a minimally invasive treatment for refractory bladder neck
contractures with a good success rate and minimal risk of side effects when a low dose of MMC is used. Further
prospective multicentre study is warranted.
Level of evidence: Level 4.
Keywords
Mitomycin, prostatectomy, transurethral resection of prostate, urethral stricture
Date received: 20 June 2020; accepted: 28 August 2020
Introduction
Bladder neck contracture (BNC) and vesicourethral anastomosis
stenosis (VUAS) are known complications of endoscopic
prostatectomy and radical prostatectomy, respectively.
The rates of VUAS following radical prostatectomy range
from 0% to 9%1-4 in contemporary series, and are lower following
robotic-assisted radical prostatectomy compared with
retropubic radical prostatectomy.1,3,4 The rates of BNC following
endoscopic prostatectomy range from 1% to 9.7%,
with various different modalities of treatment.5-7 The majority
of BNC and VUAS are amenable to endoscopic
management such as urethral dilation or bladder neck incision
(BNI), with success rates of 73.1-86% following two procedures.8-10
For patients with refractory BNC or VUAS, several
1Department of Urology, Western Health, Melbourne, Australia
2Eastern Health Clinical School, Monash University, Melbourne, Australia
3MURAC Health, Melbourne, Australia
Corresponding author:
Henry H. Yao, Western Health, 160 Gordon Street, Footscray,
Melbourne, VIC 3011, Australia.
Email: henry.yao@monash.edu
https://uk.sagepub.com/en-gb/journals-permissions https://www.doi.org/10.1177/2051415820961901 https://journals.sagepub.com/home/uro

JCU - January 2022

Table of Contents for the Digital Edition of JCU - January 2022

Contents
JCU - January 2022 - Cover1
JCU - January 2022 - Contents
JCU - January 2022 - 2
JCU - January 2022 - 3
JCU - January 2022 - 4
JCU - January 2022 - 5
JCU - January 2022 - 6
JCU - January 2022 - 7
JCU - January 2022 - 8
JCU - January 2022 - 9
JCU - January 2022 - 10
JCU - January 2022 - 11
JCU - January 2022 - 12
JCU - January 2022 - 13
JCU - January 2022 - 14
JCU - January 2022 - 15
JCU - January 2022 - 16
JCU - January 2022 - 17
JCU - January 2022 - 18
JCU - January 2022 - 19
JCU - January 2022 - 20
JCU - January 2022 - 21
JCU - January 2022 - 22
JCU - January 2022 - 23
JCU - January 2022 - 24
JCU - January 2022 - 25
JCU - January 2022 - 26
JCU - January 2022 - 27
JCU - January 2022 - 28
JCU - January 2022 - 29
JCU - January 2022 - 30
JCU - January 2022 - 31
JCU - January 2022 - 32
JCU - January 2022 - 33
JCU - January 2022 - 34
JCU - January 2022 - 35
JCU - January 2022 - 36
JCU - January 2022 - 37
JCU - January 2022 - 38
JCU - January 2022 - 39
JCU - January 2022 - 40
JCU - January 2022 - 41
JCU - January 2022 - 42
JCU - January 2022 - 43
JCU - January 2022 - 44
JCU - January 2022 - 45
JCU - January 2022 - 46
JCU - January 2022 - 47
JCU - January 2022 - 48
JCU - January 2022 - 49
JCU - January 2022 - 50
JCU - January 2022 - 51
JCU - January 2022 - 52
JCU - January 2022 - 53
JCU - January 2022 - 54
JCU - January 2022 - 55
JCU - January 2022 - 56
JCU - January 2022 - 57
JCU - January 2022 - 58
JCU - January 2022 - 59
JCU - January 2022 - 60
JCU - January 2022 - 61
JCU - January 2022 - 62
JCU - January 2022 - 63
JCU - January 2022 - 64
JCU - January 2022 - 65
JCU - January 2022 - 66
JCU - January 2022 - 67
JCU - January 2022 - 68
JCU - January 2022 - 69
JCU - January 2022 - 70
JCU - January 2022 - 71
JCU - January 2022 - 72
JCU - January 2022 - 73
JCU - January 2022 - 74
JCU - January 2022 - 75
JCU - January 2022 - 76
JCU - January 2022 - 77
JCU - January 2022 - 78
JCU - January 2022 - Cover3
JCU - January 2022 - Cover4
https://www.nxtbookmedia.com