{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T13:08:18Z","timestamp":1782306498440,"version":"3.54.5"},"reference-count":27,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2024,12,12]],"date-time":"2024-12-12T00:00:00Z","timestamp":1733961600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Urologia"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>Vesicourethral anastomosis stenosis (VUAS) is a well-known complication of prostate cancer treatments, observed in up to 26% of the cases after radical prostatectomy. Conservative management, with single or even repeated transurethral dilation or endoscopic incision of the stenosis, is successful in many cases, but up to 9% of patients are destined to fail after endoscopic treatment. In these cases, a revision of the vesicourethral anastomosis is necessary and can be realized with different surgical approaches. We aim to describe the technique and the outcomes of a new prerectal approach for VUAS repair.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>Twelve patients with recalcitrant VUAS following radical prostatectomy were enrolled between May 2014 and September 2018 for prerectal transperineal re-anastomosis. The evaluated outcomes were: the rate of successful anatomical repair at 3\u2009months after surgery and at the last follow-up, postoperative incontinence and complications rate, and the need for further treatments.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>No major intraoperative complications occurred. After a median follow-up of 46\u2009months (IQR 36\u201355), 10 patients (83.3%) achieved a good anatomical repair even if one man required an endoscopic urethrotomy, while two patients (16.67%) with a history of pelvic radiotherapy developed a surgical site infection that required toilette and external urinary diversion. Among the others, nine (75%) developed severe stress urinary incontinence, with resolution of their condition. No patient reported significant postoperative pain or fecal incontinence.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>The prerectal approach to VUAS repair allows direct access to the posterior urethra and the anastomosis, providing a better mobilization of the bladder neck for tension-free anastomosis. However, patients with a history of pelvic radiotherapy have a higher risk of complications. Postoperative incontinence is very common, but urinary continence could be restored with subsequent artificial urinary sphincter placement.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1177\/03915603241300877","type":"journal-article","created":{"date-parts":[[2024,12,13]],"date-time":"2024-12-13T07:42:33Z","timestamp":1734075753000},"page":"335-341","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["A new approach to repair recurrent vescicourethral anastomotic strictures after radical prostatectomy: The use of prerectal access"],"prefix":"10.1177","volume":"92","author":[{"given":"Antonio","family":"Vitarelli","sequence":"first","affiliation":[{"name":"Urology Unit, Mater Dei Hospital, Bari, Italy"},{"name":"Department of Emergency and Organ Transplantation \u2013 Urology Unit, Aldo Moro University, Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9893-4375","authenticated-orcid":false,"given":"Paolo","family":"Minafra","sequence":"additional","affiliation":[{"name":"Urology Unit, Mater Dei Hospital, Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Vulpi","sequence":"additional","affiliation":[{"name":"Department of Emergency and Organ Transplantation \u2013 Urology Unit, Aldo Moro University, Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Piana","sequence":"additional","affiliation":[{"name":"Department of Oncology, Division of Urology, University of Turin, San Luigi Gonzaga Hospital, Orbassano, Piemonte, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Torre","sequence":"additional","affiliation":[{"name":"Urology Unit, Mater Dei Hospital, Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Umberto","family":"Carbonara","sequence":"additional","affiliation":[{"name":"Department of Emergency and Organ Transplantation \u2013 Urology Unit, Aldo Moro University, Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucia","family":"Divenuto","sequence":"additional","affiliation":[{"name":"Department of Emergency and Organ Transplantation \u2013 Urology Unit, Aldo Moro University, Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Papapicco","sequence":"additional","affiliation":[{"name":"Department of Emergency and Organ Transplantation \u2013 Urology Unit, Aldo Moro University, Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Chiaradia","sequence":"additional","affiliation":[{"name":"Romolo Hospital, Rocca di Neto (KR), Rocca di Neto, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano","family":"Alba","sequence":"additional","affiliation":[{"name":"Romolo Hospital, Rocca di Neto (KR), Rocca di Neto, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Lucarelli","sequence":"additional","affiliation":[{"name":"Urology Unit, Mater Dei Hospital, Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele","family":"Battaglia","sequence":"additional","affiliation":[{"name":"Urology Unit, Mater Dei Hospital, Bari, Italy"},{"name":"Department of Emergency and Organ Transplantation \u2013 Urology Unit, Aldo Moro University, Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pasquale","family":"Ditonno","sequence":"additional","affiliation":[{"name":"Urology Unit, Mater Dei Hospital, Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,12,12]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.3389\/fsurg.2020.587271"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1177\/1756287217701391"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.12954\/PI.13034"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12894-015-0059-9"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2007.12.013"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2010.11.022"},{"key":"e_1_3_2_8_2","unstructured":"Uroweb - European Association of Urology [Internet]. 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