[Perineal, endoscopic desobliteration of a complete anastomotic stricture following a salvage radical prostatectomy].

INTRODUCTION

Anastomotic strictures are a known complication following a radical prostatectomy for prostate cancer. In rare cases there can be a complete displacement of the urethral anastomosis region. Treating this obstruction poses a technical challenge. Therapy includes open reconstruction of the bladder neck, continent stoma but also often only a suprapubic urinary diversion. A problem occurs when precisely this diversion has to be removed.

CASE REPORT: We report on a 68-year-old patient who, due to recurrent post operative and post radiogenic anastomotic strictures, has been fitted with a suprapubic urinary drainage device. Following an infection that spread locally, the patient developed symphysitis that had to be treated surgically. As a result, it became necessary to switch the urine drainage system. As a result of a perineal puncture of the urethra and scarring obliteration into the bladder it was possible to establish a transurethral catheter. The needle was guided by means of endoscopic view and transrectal ultrasound.

CONCLUSION

This case demonstrates a method to re-establish a transurethral urinary diversion in cases of complete anastomotic strictures.