JCU - January 2022 - 49

Yao et al.
49
Table 2. Summary of studies on management of bladder neck contracture or vesicourethral anastomotic stenosis using bladder neck incision and intra-lesional mitomycin C
injections.
Study
Current
study
No. of
patients
10
Age (years)
Median=68
(IQR 62-71)
Follow-up
Median=16.4
months (IQR
11.6-27.9)
Cause of BNC or VUAS
Radiation
history
See Table 1
n=4
(40%)
No. of prior BNC
or VUAS treatments
Median=3
(IQR
2-4)
Operative method
Collins knife deep
lateral incision at 3 and
9 o'clock
Injection site of
MMC
4 injection sites:
3 and 9 o'clock at
bladder neck and
then 1-2 cm away
from bladder
neck
Sourial
et al.
2017
29
Median=67
(IQR 63-72)
Median=58
months (IQR
48-77)
ORP (n=25) and LRP
(n=4)
n=8
(27.6%)
Median=2 (IQR
1-3)
Serial dilation over
guidewire to 26Fr
Timing of
MMC injection
Incision
prior
to
MMC
injection
Dose of MMC
Size of
urethral
catheter
1 mg in 10 mL
N/S for first
procedure and
4 mg in 10 mL
N/S for second
procedure
3, 6 and 9 o'clock MMC
injection
prior to
dilation
0.1 mg in 2 mL
N/S (0.05 mg/
mL)
22Fr
Days
of
IDC
7
No serious
adverse events
70% success
after one
procedure
and 80%
success
after two
procedures
16Fr
3
No serious
adverse events
79% success
after one
procedure
and 86%
success
after two
procedures
Farrell
et al.
2015
11
*M=59
(SD=14.8)
*Median=23
months (IQR
12-39)
*Brachytherapy alone
(n=9); Brachytherapy
and EBRT (n=2); urethral
instrumentation (n=9);
RP (n=7); infection (n=3);
hypospadias requiring
paediatric repair (n=3);
external trauma to the
urethra (n=2)
n=1
(9.1%)
*M=2.7 (SD=1.6)
Cold-knife incision at
3, 9 and 12 o'clock┬▒6
o'clock
At various points
along each
incision, i.e. at 3, 9
and 12┬▒6 o'clock
Incision
prior to
MMC
injection
4 mg in 10 mL
N/S (0.4 mg/mL)
16-18Fr
5-7
*5/37 (13.5%)
including erectile
dysfunction,
acute renal
failure,
haematuria
requiring
transfusion,
haematuria
requiring
endoscopic
management, and
laryngospasm
(Continued)
72.7%
success
Adverse events
Outcome

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