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Management of male posterior urethral stenosis following trauma and prostatic treatments, techniques and results. Le traitement des sténoses urétrales postérieures masculines : post traumatiques et post traitements à visée prostatique, techniques et résultats
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Edité par CCSD -
National audience. INTRODUCTION: Posterior Urethral Stenosis (PUS) is a surgical challenge. The aim of this article is to summarize current knowledge on the management of PUS. MATERIAL AND METHODS: A comprehensive literature review was conducted using the PubMed database, covering the period from 2020 to 2023. To supplement this review, recommendations from the American Urological Association (AUA), European Association of Urology (EAU), and Canadian Urological Association (CUA), along with several key reference surgical guides, were incorporated. The collected data was then summarized by etiology to provide a detailed analysis. RESULTS: Pelvic Fracture Urethral Injury (PFUI) is a frequent complication of pelvic fractures. Treatments are well-established, including early realignment and excision-primary-anastomosis (EPA). Stenosis following treatment for benign prostatic hyperplasia (BPH) presents specific challenges due to the high risk of urinary incontinence. The management of post-prostatectomy stenoses stenosis depends on the stricture’s location and may involve endoscopic treatment or complex reconstruction. Stenosis following radiotherapy presents additional complexity due to poor tissue quality. The impact on urinary and sexual function varies by etiology and must be considered when choosing a treatment approach. CONCLUSION: The management of PUS must consider the precise location and etiology of the stenosis. Treatment options vary from endoluminal techniques to open or robot-assisted reconstructions, chosen based on the patient’s goals and overall health condition. Special attention must be given to the potential impact on urinary and sexual function.
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