Interventional Radiology Methods for the Correction of Postoperative Urinary Structures after Surgical Treatment for Prostate and Bladder Cancer

Purpose: To determine the possibility of interventional radiology correction of postoperative non-tumor urinary tract strictures in the surgical treatment of prostate and bladder cancer.

Material and methods: The results of interventional radiology treatment of 10 patients with non-tumor local non-traumatic urinary tract strictures were subjected to a retrospective analysis. In 6 cases, patients had strictures of the cystourethral anastomoses, in 3 cases – strictures of the ureteral orifices after paraostial transurethral resection of the bladder, in 1 cases – a stricture of the ileoureteral anastomosis after orthotopic ileocytoplasty. All patients underwent balloon dilatation of strictures with antegrade or retrograde access. The target criterion was the disappearance of the waist of a balloon with a diameter of 8 mm at a pressure of from 3 to 12 atm with an exposure of 5 minutes. The intervention was completed frame drainage zone of the anastomosis.

Results: We observed no complications associated with the intervention technique. Immediate success was achieved in all 10 patients. Recurrent stricture occurred in 3 patients with a cystourethral anastomosis stricture and 1 patient with a ureteral orifice stricture between 1 year and 3 years and required repeated interventional radiology treatment. The maximum term of recurrence-free observation was 5.5 years.

Conclusion: Balloon dilatation of postoperative urinary tract strictures is the method of choice in the staged treatment of patients with bladder or prostate cancer, primarily from the standpoint of its safety for the patient and the possibility of re-intervention in recurrent stricture.

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