Transurethral Incision With Transverse Mucosal Realignment for the Treatment of Bladder Neck Contractures After Benign Prostate Surgery; Mid-term Outcomes.

OBJECTIVE

To describe mid-term anatomic and functional outcomes of a novel endoscopic treatment, transurethral incision with transverse mucosal realignment (TUITMR), for bladder neck contracture (BNC) following benign prostatic hyperplasia (BPH) surgery.

METHODS

We retrospectively reviewed a prospectively maintained registry of men undergoing TUITMR for BNC following BPH surgery between November 2021 and July 2025. Primary outcomes were anatomic success (cystoscopic patency) and freedom from reintervention. Secondary outcomes included functional success, symptom scores (IPSS), post-void residual (PVR), continence, and complications.

RESULTS

Ninety-two patients were analyzed with median follow-up of 15.9 months (IQR 8.8-22.4). Primary anatomic success was achieved in 93.5% of patients. Freedom from reintervention after a single procedure was 83.7%. Among patients requiring retreatment, repeat TUITMR resulted in high salvage rates, yielding overall clinical success of 93.5% and final anatomic success of 96.7% after up to 2 procedures. No patients had de novo incontinence. Complications occurred in 12% of patients, predominantly minor urinary tract infections, with rare need for secondary intervention.

CONCLUSION

TUITMR achieves high anatomic and durable clinical success for BNC following BPH surgery, with excellent salvage potential after retreatment and low morbidity.