Cancer UrologyCancer UrologyОнкоурология1726-97761996-1812Publishing House ABV Press62510.17650/1726-9776-2017-13-1-85-90PROSTATE CANCERРАК ПРЕДСТАТЕЛЬНОЙ ЖЕЛЕЗЫNew model of urethral catheter in treatment of patients after radical prostatectomy: efficiency and possibilities of implementation into clinical practiceНовая модель уретрального катетера в лечении больных, перенесших радикальную простатэктомию: эффективность и возможность внедрения в клиническую практикуVasilyevA. O.ВасильевА. О
Russian Federation

Urology Department

Контакты: Александр Олегович Васильев, ассистент кафедры урологии 

127473 Москва, ул. Делегатская, 20, стр. 1 

doctormma@yandex.ruGovorovA. V.ГоворовА. В.
Russian Federation

Urology Department

Александр Викторович Говоров, кафедра урологии 

alexgovorov@newmail.ruRevaI. A.РеваИ. А.
Russian Federation

Urology Department

Игорь Анатольевич Рева, кафедра урологии 

doctormma@yandex.ruPushkar’D. Yu.ПушкарьД. Ю.
Russian Federation

Urology Department

Дмитрий Юрьевич Пушкарь, кафедра урологии 

 

doctormma@yandex.ruA.I. Evdokimov Moscow State University of Medicine and DentistryМосковский государственный медико-стоматологический университет им. А.И. Евдокимова3003201713185903110201612032017https://oncourology.abvpress.ru/oncur/article/view/625

Vesicourethral anastomosis (VUA) stricture applies to late postoperative complications of radical prostatectomy significantly reduces the quality of life of patients. Factors significantly affecting the rate of stricture formation VUA are not well understood, exactly how is not fully understood the mechanism of its development. Common approach to the treatment of these patients does not exist. The most common and less traumatic treatment methods include bougienage, internal optical urethrotomy and transurethral resection VUA. Given the high rate of relapse after such endoscopic surgery by many authors to optimize surgical care to patients with VUA stricture it has been proposed, however the prevention of its development measures still exists. Developed at the Urology Department of A.I. Evdokimov Moscow State University of Medicine and Dentistry new model of urinary catheter can take place in certain methods of prevention and treatment of strictures VUA. 

Стриктура везикоуретрального анастомоза (ВУА) относится к поздним послеоперационным осложнениям радикальной простатэктомии и значительно снижает качество жизни больных. Факторы, достоверно влияющие на частоту формирования стриктуры ВУА, изучены недостаточно, ровно как до конца не ясен механизм ее развития. Единого подхода к лечению данной категории пациентов также не существует. К самым распространенным и малотравматичным методам лечения относят бужирование, внутреннюю оптическую уретротомию и трансуретральную резекцию зоны ВУА. С учетом высокой частоты возникновения рецидивов после подобных эндоскопических операций многими авторами была предложена оптимизация хирургической техники больным со стриктурой ВУА, тем не менее мер по ее профилактике по-прежнему не существует. Разработанная на кафедре урологии МГМСУ им. А.И. Евдокимова новая модель уретрального катетера может занять определенное место в методах профилактики и лечения стриктур ВУА. 

radical prostatectomypostoperative complicationvesicourethral anastomosis stricturenew model of the urethral catheterрадикальная простатэктомияпослеоперационное осложнениестриктура везикоуретрального анастомозановая модель уретрального катетераРоссийский научный фонд (соглашение №16-15-00233)1. Kundu S.D., Roehl K.A., Eggener S.E. et al. Potency, continence and complications in 3,477 consecutive radical retropubic prostatectomies. J Urol 2004;172(6, Pt 1): 2227–31. PMID: 15538237.Kundu S.D., Roehl K.A., Eggener S.E. et al. Potency, continence and complications in 3,477 consecutive radical retropubic prostatectomies. J Urol 2004;172(6, Pt 1): 2227–31. PMID: 15538237.2. Kao T.C., Cruess D.F., Garner D. et al. Multicenter patient self-reporting questionnaire on impotence, incontinence and stricture after radical prostatectomy. J Urol 2000;163(3): 858–64. PMID: 10687992.Kao T.C., Cruess D.F., Garner D. et al. Multicenter patient self-reporting questionnaire on impotence, incontinence and stricture after radical prostatectomy. J Urol 2000;163(3): 858–64. PMID: 10687992.3. Mottrie A., Van Migem P., De Naeyer G. et al. Robot-assisted laparoscopic radical prostatectomy: oncologic and functional results of 184 cases. Eur Urol 2007;52(3): 746–50. DOI: 10.1016/j.eururo.2007.02.029. PMID: 17329020.Mottrie A., Van Migem P., De Naeyer G. et al. Robot-assisted laparoscopic radical prostatectomy: oncologic and functional results of 184 cases. Eur Urol 2007;52(3): 746–50. DOI: 10.1016/j.eururo.2007.02.029. PMID: 17329020.4. Herrmann T.R., Rabenalt R., Stolzenburg J.U. et al. Oncological and functional results of open, robot-assisted and laparoscopic radical prostatectomy: does surgical approach and surgical experience matter? World J Urol 2007;25(2):149–60. DOI: 10.1007/s00345-007-0164-9. PMID: 17354014.Herrmann T.R., Rabenalt R., Stolzenburg J.U. et al. Oncological and functional results of open, robot-assisted and laparoscopic radical prostatectomy: does surgical approach and surgical experience matter? World J Urol 2007;25(2):149–60. DOI: 10.1007/s00345-007-0164-9. PMID: 17354014.5. Herschorn S., Elliott S., Coburn M. et al. SIU/ICUD consultation on urethral strictures: posterior urethral stenosis after treatment of prostate cancer. Urology 2014;83(3):59–70. DOI: 10.1016/j.urology.2013.08.036. PMID: 24361008.Herschorn S., Elliott S., Coburn M. et al. SIU/ICUD consultation on urethral strictures: posterior urethral stenosis after treatment of prostate cancer. Urology 2014;83(3):59–70. DOI: 10.1016/j.urology.2013.08.036. PMID: 24361008.6. Busch J., Gonzalgo M.L., Leva N. et al. Matched comparison of robot-assisted, laparoscopic and open radical prostatectomy regarding pathologic and oncologic outcomes in obese patients. World J Urol 2015;33(3):397–402. DOI: 10.1007/s00345-014-1326-1. PMID: 24853030.Busch J., Gonzalgo M.L., Leva N. et al. Matched comparison of robot-assisted, laparoscopic and open radical prostatectomy regarding pathologic and oncologic outcomes in obese patients. World J Urol 2015;33(3):397–402. DOI: 10.1007/s00345-014-1326-1. PMID: 24853030.7. Rassweiler J., Stolzenburg J., Sulser T. et al. Laparoscopic radical prostatectomy – the experience of the German Laparoscopic Working Group. Eur Urol 2006;49(1):113–9. DOI: 10.1016/j.eururo.2005.10.003. PMID: 16337330.Rassweiler J., Stolzenburg J., Sulser T. et al. Laparoscopic radical prostatectomy – the experience of the German Laparoscopic Working Group. Eur Urol 2006;49(1):113–9. DOI: 10.1016/j.eururo.2005.10.003. PMID: 16337330.8. Лоран О.Б., Велиев Е.И., Петров С.Б. и др. Стриктура уретровезикального анастомоза после радикальной позадилонной простатэктомии: распространенность и факторы прогноза. Медицинский альманах 2014;3(33):146–9. [Loran O.B., Veliev E.I., Petrov S.B. et al. Stricture of urethrovesical anastomosis after radical retropubic prostatectomy: prevalence and prognostic factors. Meditsinskiy almanakh = Medical Almanac 2014;3(33):146–Лоран О.Б., Велиев Е.И., Петров С.Б. и др. Стриктура уретровезикального анастомоза после радикальной позадилонной простатэктомии: распространенность и факторы прогноза. Медицинский альманах 2014;3(33):146–9. [Loran O.B., Veliev E.I., Petrov S.B. et al. Stricture of urethrovesical anastomosis after radical retropubic prostatectomy: prevalence and prognostic factors. Meditsinskiy almanakh = Medical Almanac 2014;3(33):146–9. (In Russ.)]. 9. Futao S., Wentong Z., Yan Z. et al. Application of endoscopic Ho: YAG laser incision technique treating urethral strictures and urethral atresias in pediatric patients. Pediatr Surg Int 2006;22(6):514–8. DOI: 10.1007/s00383-006-1692-x. PMID: 16736220.(In Russ.)]. 9. Futao S., Wentong Z., Yan Z. et al. Application of endoscopic Ho: YAG laser incision technique treating urethral strictures and urethral atresias in pediatric patients. Pediatr Surg Int 2006;22(6):514–8. DOI: 10.1007/s00383-006-1692-x. PMID: 16736220.10. Elliott S.P., McAninch J.W. The current role of urethrotomy in anterior urethral stricture disease. Curr Urol Rep 2006;7(5):339–40. PMID: 16959172.Elliott S.P., McAninch J.W. The current role of urethrotomy in anterior urethral stricture disease. Curr Urol Rep 2006;7(5):339–40. PMID: 16959172.11. Theodoros C., Katsifotis C., Stournaras P. et al. Abdomino-perineal repair of recurrent and complex bladder neck-prostatic urethra contractures. Eur Urol 2000;38(6):734–40. DOI: 20371. PMID: 11111193.Theodoros C., Katsifotis C., Stournaras P. et al. Abdomino-perineal repair of recurrent and complex bladder neck-prostatic urethra contractures. Eur Urol 2000;38(6):734–40. DOI: 20371. PMID: 11111193.12. Schlossberg S., Jordan G., Schellhammer P. Repair of obliterative vesicourethral stricture after radical prostatectomy: a technique for preservation of continence. Urology 1995;45(3):510–3. DOI: 10.1016/S0090-4295(99)80025-9. PMID: 7879341.Schlossberg S., Jordan G., Schellhammer P. Repair of obliterative vesicourethral stricture after radical prostatectomy: a technique for preservation of continence. Urology 1995;45(3):510–3. DOI: 10.1016/S0090-4295(99)80025-9. PMID: 7879341.13. Simonato A., Gregpry A., Lissiani A. et al. Two-stage transperineal management of posterior urethral strictures or bladder neck contractures associated with urinary incontinence after prostate surgery and endoscopic treatment failures. Eur Urol 2007;52(5):1499–504. DOI: 10.1016/j.eururo.2007.03.053. PMID: 17418481.Simonato A., Gregpry A., Lissiani A. et al. Two-stage transperineal management of posterior urethral strictures or bladder neck contractures associated with urinary incontinence after prostate surgery and endoscopic treatment failures. Eur Urol 2007;52(5):1499–504. DOI: 10.1016/j.eururo.2007.03.053. PMID: 17418481.14. Патент регистрационный № 2015105710 «Способ предотвращения развития сужения сформированного уретрошеечного анастомоза в раннем послеоперационном периоде простатэктомии». Д.Ю. Пушкарь, Г.Т. Сухих, М.Г. Шнейдерман и др. [Patent, registration № 2015105710 “Method for prevention of narrowing of a formed urethrocervical anastomosis in early postoperative period after prostatectomy.”D.Yu. Pushkar’, G.T. Sukhikh, M.G. Shneyderman et al. (In Russ.)].Патент регистрационный № 2015105710 «Способ предотвращения развития сужения сформированного уретрошеечного анастомоза в раннем послеоперационном периоде простатэктомии». Д.Ю. Пушкарь, Г.Т. Сухих, М.Г. Шнейдерман и др. [Patent, registration № 2015105710 “Method for prevention of narrowing of a formed urethrocervical anastomosis in early postoperative period after prostatectomy.”D.Yu. Pushkar’, G.T. Sukhikh, M.G. Shneyderman et al. (In Russ.)].15. Wang R., Wood D.P. Jr, Hollenbeck B.K. Risk factors and quality of life for postprostatectomy vesicourethral anastomotic stenosis. Urology 2012;79(2):449–57. DOI: 10.1016/j.urology.2011.07.1383. PMID: 22196405.Wang R., Wood D.P. Jr, Hollenbeck B.K. Risk factors and quality of life for postprostatectomy vesicourethral anastomotic stenosis. Urology 2012;79(2):449–57. DOI: 10.1016/j.urology.2011.07.1383. PMID: 22196405.16. Breyer B.N., Davis C.B., Cowan J.E. et al. Incidence of bladder neck contracture after robot-assisted laparoscopic and open radical prostatectomy. BJU Int 2010;106(11):1734–8. DOI: 10.1111/j.1464-410X.2010.09333.x. PMID: 20438567.Breyer B.N., Davis C.B., Cowan J.E. et al. Incidence of bladder neck contracture after robot-assisted laparoscopic and open radical prostatectomy. BJU Int 2010;106(11):1734–8. DOI: 10.1111/j.1464-410X.2010.09333.x. PMID: 20438567.17. Carlsson S., Nilsson A.E., Schumacher M.C. et al. Surgery-related complications in 1253 robotassisted and 485 open retropubic radical prostatectomies at the Karolinska University Hospital, Sweden. Urology 2010;75(5):1092–7. DOI: 10.1016/j.urology.2009.09.075. PMID: 20022085.Carlsson S., Nilsson A.E., Schumacher M.C. et al. Surgery-related complications in 1253 robotassisted and 485 open retropubic radical prostatectomies at the Karolinska University Hospital, Sweden. Urology 2010;75(5):1092–7. DOI: 10.1016/j.urology.2009.09.075. PMID: 20022085.18. Choi W.W., Gu X., Lipsitz S.R. et al. The effect of minimally invasive and open radical prostatectomy surgeon volume. Urol Oncol 2012;30(5):569–76. DOI: 10.1016/j.urolonc.2010.06.009. PMID: 20822929.Choi W.W., Gu X., Lipsitz S.R. et al. The effect of minimally invasive and open radical prostatectomy surgeon volume. Urol Oncol 2012;30(5):569–76. DOI: 10.1016/j.urolonc.2010.06.009. PMID: 20822929.19. Ouzaid I., Xylinas E., Ploussard G. et al. Anastomotic stricture after minimally invasive radical prostatectomy: what should be expected from the Van Velthoven single-knot running suture? J Endourol 2012;26(8):1020–5. DOI: 10.1089/end.2011.0650. PMID: 22486229.Ouzaid I., Xylinas E., Ploussard G. et al. Anastomotic stricture after minimally invasive radical prostatectomy: what should be expected from the Van Velthoven single-knot running suture? J Endourol 2012;26(8):1020–5. DOI: 10.1089/end.2011.0650. PMID: 22486229.20. Muñoz D., Vicens A., García-Montes F. Vesicourethral anastomotic stricture following radical prostatectomy with or without postoperative radiotherapy. Actas Urol Esp 2011;35(5):277–81. DOI: 10.1016/j.acuro.2011.01.003.Muñoz D., Vicens A., García-Montes F. Vesicourethral anastomotic stricture following radical prostatectomy with or without postoperative radiotherapy. Actas Urol Esp 2011;35(5):277–81. DOI: 10.1016/j.acuro.2011.01.003.21. Раснер П.И., Котенко Д.В., Пушкарь Д.Ю., Герасимов А.Н. Осложнения РАРП и факторы риска их возникновения: анализ первых 512 операций с продолжительностью наблюдения 12 месяцев. Вестник Национального медико-хирургического центра им. Н.И. Пирогова 2015;1(1):45–51. [Rasner P.I., Kotenko D.V., Pushkar’ D.Yu., Gerasimov A.N. Complications of RARP and their risk factors: аnalysis of first 512 surgeries with follow-up period of 12 months. Vestnik Natsional’nogo mediko-khirurgicheskogo tsentra im. N.I. Pirogova = Bulletin of N.I. Pirogov National Medical and Surgical Center 2015;1(1):45–51. (In Russ.)].Раснер П.И., Котенко Д.В., Пушкарь Д.Ю., Герасимов А.Н. Осложнения РАРП и факторы риска их возникновения: анализ первых 512 операций с продолжительностью наблюдения 12 месяцев. Вестник Национального медико-хирургического центра им. Н.И. Пирогова 2015;1(1):45–51. [Rasner P.I., Kotenko D.V., Pushkar’ D.Yu., Gerasimov A.N. Complications of RARP and their risk factors: аnalysis of first 512 surgeries with follow-up period of 12 months. Vestnik Natsional’nogo mediko-khirurgicheskogo tsentra im. N.I. Pirogova = Bulletin of N.I. Pirogov National Medical and Surgical Center 2015;1(1):45–51. (In Russ.)].22. Parihar J.S., Ha Y.S., Kim I.Y. Bladder neck contracture-incidence and management following contemporary robot assisted radical prostatectomy technique. Prostate Int 2014;2(1):12–8. DOI: 10.12954/PI.13034. PMID: 24693529.Parihar J.S., Ha Y.S., Kim I.Y. Bladder neck contracture-incidence and management following contemporary robot assisted radical prostatectomy technique. Prostate Int 2014;2(1):12–8. DOI: 10.12954/PI.13034. PMID: 24693529.23. Kim J.C., Cho K.J. Current trends in the management of post-prostatectomy incontinence. Korean J Urol 2012;53(8):511–8. DOI: 10.4111/kju.2012.53.8.511. PMID: 22949993.Kim J.C., Cho K.J. Current trends in the management of post-prostatectomy incontinence. Korean J Urol 2012;53(8):511–8. DOI: 10.4111/kju.2012.53.8.511. PMID: 22949993.24. Coburn M. Posterior urethral complications of radical prostatectomy. Can Urol Assoc J 2013;7(9–10 Suppl 4):192–4. DOI: 10.5489/cuaj.1622. PMID: 24523843.Coburn M. Posterior urethral complications of radical prostatectomy. Can Urol Assoc J 2013;7(9–10 Suppl 4):192–4. DOI: 10.5489/cuaj.1622. PMID: 24523843.