Laparoscopic Bladder Neck Wedge Resection with Preservation of the Posterior Urethral Bed Versus Transurethral Resection of the Bladder Neck for Refractory Bladder Neck Contracture: A Comparative Study

Background and objective: Refractory bladder neck contracture (BNC) poses significant challenges after transurethral resection of the prostate. This study compares laparoscopic bladder neck wedge resection with posterior urethral bed preservation (LCBNRE) versus transurethral resection of the bladde...

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Main Authors: Zhize Wang, Jiayidaer Dannier, Yeqing Mao, Nieying Ma, Lugeng He, Sihai Shao, Jianjun Yu
Format: Article
Language:English
Published: Elsevier 2025-09-01
Series:European Urology Open Science
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Online Access:http://www.sciencedirect.com/science/article/pii/S2666168325002836
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author Zhize Wang
Jiayidaer Dannier
Yeqing Mao
Nieying Ma
Lugeng He
Sihai Shao
Jianjun Yu
author_facet Zhize Wang
Jiayidaer Dannier
Yeqing Mao
Nieying Ma
Lugeng He
Sihai Shao
Jianjun Yu
author_sort Zhize Wang
collection DOAJ
description Background and objective: Refractory bladder neck contracture (BNC) poses significant challenges after transurethral resection of the prostate. This study compares laparoscopic bladder neck wedge resection with posterior urethral bed preservation (LCBNRE) versus transurethral resection of the bladder neck (TURBN) in managing refractory BNC. Methods: A retrospective analysis was conducted of 103 patients (2018–2023) divided into the LCBNRE (n = 58) and TURBN (n = 45) groups. Outcomes included operative parameters, urodynamics, International Prostate Symptom Score, and recurrence rates. Key findings and limitations: LCBNRE showed longer operative time (100 vs 43 min, p < 0.01) but lower 30-d reoperation (1.7% vs 31.1%, p < 0.01) and recurrence (5.2% vs 28.9%, p = 0.01) rates. Urodynamic improvements favored LCBNRE (p < 0.01). Limitations include single-center design and short follow-up. Conclusions and clinical implications: LCBNRE is more effective for refractory BNC, with durable outcomes. Multicenter randomized trials are needed for validation. Patient summary: This study compared two surgical methods for bladder neck scarring. The laparoscopic approach resulted in better urine flow, fewer repeat surgeries, and lower recurrence rates than traditional methods.
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spelling doaj-art-7f7b2b3e6fbb486fa137c7118934a0d72025-08-20T04:02:32ZengElsevierEuropean Urology Open Science2666-16832025-09-01799310110.1016/j.euros.2025.07.014Laparoscopic Bladder Neck Wedge Resection with Preservation of the Posterior Urethral Bed Versus Transurethral Resection of the Bladder Neck for Refractory Bladder Neck Contracture: A Comparative StudyZhize Wang0Jiayidaer Dannier1Yeqing Mao2Nieying Ma3Lugeng He4Sihai Shao5Jianjun Yu6Department of Urology, the First Affiliated Hospital, Zhejiang University, School of Medicine, Hangzhou, ChinaDepartment of Urology, the First Affiliated Hospital, Zhejiang University, School of Medicine, Hangzhou, ChinaDepartment of Urology, the First Affiliated Hospital, Zhejiang University, School of Medicine, Hangzhou, ChinaWomen’s Hospital, Zhejiang University School of Medicine, Hangzhou, ChinaDepartment of Urology, the First Affiliated Hospital, Zhejiang University, School of Medicine, Hangzhou, China; Corresponding authors. First Affiliated Hospital, Zhejiang University School of Medicine, 79th Qingchun Rd, Hangzhou 310003, China. Tel. +8618930177552; Fax: +8687236114.Department of Urology, The First People’s Hospital of Huzhou, Huzhou, ChinaDepartment of Urology, the First Affiliated Hospital, Zhejiang University, School of Medicine, Hangzhou, China; Corresponding authors. First Affiliated Hospital, Zhejiang University School of Medicine, 79th Qingchun Rd, Hangzhou 310003, China. Tel. +8618930177552; Fax: +8687236114.Background and objective: Refractory bladder neck contracture (BNC) poses significant challenges after transurethral resection of the prostate. This study compares laparoscopic bladder neck wedge resection with posterior urethral bed preservation (LCBNRE) versus transurethral resection of the bladder neck (TURBN) in managing refractory BNC. Methods: A retrospective analysis was conducted of 103 patients (2018–2023) divided into the LCBNRE (n = 58) and TURBN (n = 45) groups. Outcomes included operative parameters, urodynamics, International Prostate Symptom Score, and recurrence rates. Key findings and limitations: LCBNRE showed longer operative time (100 vs 43 min, p < 0.01) but lower 30-d reoperation (1.7% vs 31.1%, p < 0.01) and recurrence (5.2% vs 28.9%, p = 0.01) rates. Urodynamic improvements favored LCBNRE (p < 0.01). Limitations include single-center design and short follow-up. Conclusions and clinical implications: LCBNRE is more effective for refractory BNC, with durable outcomes. Multicenter randomized trials are needed for validation. Patient summary: This study compared two surgical methods for bladder neck scarring. The laparoscopic approach resulted in better urine flow, fewer repeat surgeries, and lower recurrence rates than traditional methods.http://www.sciencedirect.com/science/article/pii/S2666168325002836LaparoscopyBladder neck contractureTransurethral resectionOutcome comparison
spellingShingle Zhize Wang
Jiayidaer Dannier
Yeqing Mao
Nieying Ma
Lugeng He
Sihai Shao
Jianjun Yu
Laparoscopic Bladder Neck Wedge Resection with Preservation of the Posterior Urethral Bed Versus Transurethral Resection of the Bladder Neck for Refractory Bladder Neck Contracture: A Comparative Study
European Urology Open Science
Laparoscopy
Bladder neck contracture
Transurethral resection
Outcome comparison
title Laparoscopic Bladder Neck Wedge Resection with Preservation of the Posterior Urethral Bed Versus Transurethral Resection of the Bladder Neck for Refractory Bladder Neck Contracture: A Comparative Study
title_full Laparoscopic Bladder Neck Wedge Resection with Preservation of the Posterior Urethral Bed Versus Transurethral Resection of the Bladder Neck for Refractory Bladder Neck Contracture: A Comparative Study
title_fullStr Laparoscopic Bladder Neck Wedge Resection with Preservation of the Posterior Urethral Bed Versus Transurethral Resection of the Bladder Neck for Refractory Bladder Neck Contracture: A Comparative Study
title_full_unstemmed Laparoscopic Bladder Neck Wedge Resection with Preservation of the Posterior Urethral Bed Versus Transurethral Resection of the Bladder Neck for Refractory Bladder Neck Contracture: A Comparative Study
title_short Laparoscopic Bladder Neck Wedge Resection with Preservation of the Posterior Urethral Bed Versus Transurethral Resection of the Bladder Neck for Refractory Bladder Neck Contracture: A Comparative Study
title_sort laparoscopic bladder neck wedge resection with preservation of the posterior urethral bed versus transurethral resection of the bladder neck for refractory bladder neck contracture a comparative study
topic Laparoscopy
Bladder neck contracture
Transurethral resection
Outcome comparison
url http://www.sciencedirect.com/science/article/pii/S2666168325002836
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