{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,7]],"date-time":"2026-02-07T11:06:36Z","timestamp":1770462396393,"version":"3.49.0"},"reference-count":108,"publisher":"MDPI AG","issue":"21","license":[{"start":{"date-parts":[[2021,10,24]],"date-time":"2021-10-24T00:00:00Z","timestamp":1635033600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Bladder outlet obstruction following treatment of pelvic cancer, predominantly prostate cancer, occurs in 1\u20138% of patients. The high incidence of prostate cancer combined with the long-life expectancy after treatment has increased concerns with cancer survivorship care. However, despite increased oncological cure rates, these adverse events do occur, compromising patients\u2019 quality of life. Non-traumatic obstruction of the posterior urethra and bladder neck include membranous and prostatic urethral stenosis and bladder neck stenosis (also known as contracture). The devastated bladder outlet can result from benign conditions, such as neurogenic dysfunction, trauma, iatrogenic causes, or more frequently from complications of oncologic treatment, such as prostate, bladder and rectum. Most posterior urethral stenoses may respond to endoluminal treatments such as dilatation, direct vision internal urethrotomy, and occasionally urethral stents. Although surgical reconstruction offers the best chance of durable success, these reconstructive options are fraught with severe complications and, therefore, are far from being ideal. In patients with prior RT, failed reconstruction, densely fibrotic and\/or necrotic and calcified posterior urethra, refractory incontinence or severe comorbidities, reconstruction may not be either feasible or recommended. In these cases, urinary diversion with or without cystectomy is usually required. This review aims to discuss the diagnostic evaluation and treatment options for patients with bladder outlet obstruction with a special emphasis on patients unsuitable for reconstruction of the posterior urethra and requiring urinary diversion.<\/jats:p>","DOI":"10.3390\/jcm10214920","type":"journal-article","created":{"date-parts":[[2021,10,24]],"date-time":"2021-10-24T22:06:16Z","timestamp":1635113176000},"page":"4920","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Devastated Bladder Outlet in Pelvic Cancer Survivors: Issues on Surgical Reconstruction and Quality of Life"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5718-6964","authenticated-orcid":false,"given":"Francisco E.","family":"Martins","sequence":"first","affiliation":[{"name":"Department of Urology, School of Medicine, University of Lisbon, Hospital Santa Maria\/CHULN, 1649-035 Lisbon, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2714-6037","authenticated-orcid":false,"given":"Henriette Veiby","family":"Holm","sequence":"additional","affiliation":[{"name":"Department of Urology, Oslo University Hospital, N-0424 Oslo, Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicolaas","family":"Lumen","sequence":"additional","affiliation":[{"name":"Department of Urology, Ghent University Hospital, 9000 Ghent, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,10,24]]},"reference":[{"key":"ref_1","first-page":"60","article-title":"Management of the devastated posterior urethra and bladder neck: Refractory incontinence and stenosis","volume":"4","author":"Anderson","year":"2015","journal-title":"Transl. Androl. Urol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1016\/j.urology.2013.09.009","article-title":"IU\/ICUD consultation on urethral strictures: Epidemiology, etiology, anatomy, and nomenclature of urethral stenoses, strictures, and pelvic fracture urethral disruption injuries","volume":"83","author":"Latini","year":"2014","journal-title":"Urology"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"983","DOI":"10.1016\/j.juro.2009.05.023","article-title":"Etiology of urethral stricture disease in the 21st century","volume":"182","author":"Lumen","year":"2009","journal-title":"J. Urol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"304","DOI":"10.1111\/j.1464-410X.2011.10864.x","article-title":"Posterior urethral complications of the treatment of prostate cancer","volume":"110","author":"Mundy","year":"2012","journal-title":"BJU Int."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1016\/j.juro.2007.03.126","article-title":"Incidence of urethral stricture after primary treatment for prostate cancer: Data from CaPSURE","volume":"178","author":"Elliott","year":"2007","journal-title":"J. Urol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"7","DOI":"10.3322\/caac.21332","article-title":"Cancer statistics, 2016","volume":"66","author":"Siegel","year":"2016","journal-title":"CA Cancer J. Clin."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"832","DOI":"10.1016\/S1470-2045(11)70187-5","article-title":"Comment on \u201cLong-term quality of life in prostate cancer\u201d","volume":"12","author":"Hamdy","year":"2011","journal-title":"Lancet Oncol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1078","DOI":"10.1200\/JCO.2014.60.2557","article-title":"Prostate cancer survivorship care guideline: American Society of Clinical Oncology Clinical Practice Guideline endorsement","volume":"33","author":"Resnick","year":"2015","journal-title":"J. Clin. Oncol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"225","DOI":"10.3322\/caac.21234","article-title":"American Cancer Society Prostate Cancer Survivorship Care Guidelines","volume":"64","author":"Skolarus","year":"2014","journal-title":"CA Cancer J. Clin."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"436","DOI":"10.1056\/NEJMoa1209978","article-title":"Long-term functional outcomes after treatment for localized prostate cancer","volume":"368","author":"Resncik","year":"2013","journal-title":"N. Engl. J. Med."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"891","DOI":"10.1016\/S1470-2045(11)70162-0","article-title":"Long-term quality-of-life outcomes after radical prostatectomyor watchful waiting: The Scandinavian Prostate Cancer Group-4 randomized trial","volume":"12","author":"Johansson","year":"2011","journal-title":"Lancet Oncol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1016\/j.eururo.2014.08.061","article-title":"Propensity-weighted long-term risk of urinary adverse events after prostate cancer surgery, radiation, or both","volume":"67","author":"Jarosek","year":"2015","journal-title":"Eur. Urol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"40405","DOI":"10.1200\/JCO.2003.05.169","article-title":"Role of surgeon volume in radical prostatectomy outcomes","volume":"21","author":"Hu","year":"2003","journal-title":"J. Clin. Oncol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1007\/s11934-017-0729-0","article-title":"Management of urethral stricture and bladder neck contracture following primary and salvage treatment of prostate cancer","volume":"18","author":"Browne","year":"2017","journal-title":"Curr. Urol. Rep."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"255. e1","DOI":"10.1016\/j.urolonc.2016.01.008","article-title":"The effect of minimally invasive prostatectomy on practice patterns of American urologists","volume":"34","author":"Oberlin","year":"2016","journal-title":"Urol. Oncol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1415","DOI":"10.1056\/NEJMoa1606220","article-title":"10-year outcomes after monitoring surgery or radiotherapy for localized prostate cancer","volume":"375","author":"Hamdy","year":"2016","journal-title":"N. Engl. J. Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1734","DOI":"10.1111\/j.1464-410X.2010.09333.x","article-title":"Incidence of bladder neck contracture after robotic-assisted laparoscopic and open radical prostatectomy","volume":"106","author":"Breyer","year":"2010","journal-title":"BJU Int."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1615","DOI":"10.1111\/j.1464-410X.2009.08700.x","article-title":"Bladder neck contracture after retropubic radical prostatectomy: Incidence and risk factors from a large single-surgeon experience","volume":"104","author":"Erickson","year":"2009","journal-title":"BJU Int."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"12","DOI":"10.12954\/PI.13034","article-title":"Bladder neck contracture, incidence and management following contemporary robot assisted radical prostatectomy technique","volume":"2","author":"Parihar","year":"2014","journal-title":"Prostate Int."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"309","DOI":"10.4111\/icu.2016.57.5.309","article-title":"Urethral strictures after radiation therapy for prostate cancer","volume":"57","author":"Moltzahn","year":"2016","journal-title":"Investig. Clin Urol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"571576","DOI":"10.1155\/2014\/571576","article-title":"Cryotherapy for primary treatment of prostate cancer: Intermediate term results of a prospective study from a single institution","volume":"2014","author":"Rodriguez","year":"2014","journal-title":"Prostate Cancer"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1016\/S1470-2045(20)30639-2","article-title":"Considering benefit and risk before routinely recommending SpaceOAR","volume":"22","author":"Hall","year":"2021","journal-title":"Lancet Oncol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"87","DOI":"10.5489\/cuaj.816","article-title":"Salvage prostatectomy post-definitive radiation therapy: The Vancouver experience","volume":"7","author":"Corcoran","year":"2013","journal-title":"Can. Urol. Assoc. J."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1993","DOI":"10.1016\/j.juro.2008.07.108","article-title":"Best practice statement on cryosurgery for the treatment of localized prostate cancer","volume":"180","author":"Babaian","year":"2008","journal-title":"J. Urol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1016\/j.brachy.2012.03.004","article-title":"Urethral strictures following high-dose-rate brachytherapy for prostate cancer: Analysis of risk factors","volume":"12","author":"Hindson","year":"2013","journal-title":"Brachytherapy"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1016\/j.radonc.2008.11.013","article-title":"Urethral stricture following high dose rate brachytherapy for prostate cancer","volume":"9","author":"Sullivan","year":"2009","journal-title":"Radiother. Oncol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1016\/j.prnil.2015.11.002","article-title":"Single-institution comparative study on the outcomes of salvage cryotherapy versus salvage robotic prostatectomy for radio-resistant prostate cancer","volume":"4","author":"Vora","year":"2016","journal-title":"Prostate Int."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1157","DOI":"10.1016\/j.urology.2014.06.054","article-title":"Salvage high-intensity focused ultrasound for patients with recurrent prostate cancer after brachytherapy","volume":"84","author":"Yutkin","year":"2014","journal-title":"Urology"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"618","DOI":"10.1016\/j.eururo.2012.11.057","article-title":"Morbidity of focal therapy in the treatment of localized prostate cancer","volume":"63","author":"Barrett","year":"2013","journal-title":"Eur. Urol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1093\/jjco\/hym173","article-title":"Focal therapy with high-intensity-focused ultrasound in the treatment of localized prostate cancer","volume":"38","author":"Muto","year":"2008","journal-title":"Jpn. J. Clin. Oncol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1156","DOI":"10.1097\/01.ju.0000155534.54711.60","article-title":"Salvage surgery for radiorecurrent prostate cancer: Contemporary outcomes","volume":"173","author":"Ward","year":"2005","journal-title":"J. Urol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1016\/j.urology.2006.09.058","article-title":"Prostate-specific antigen control with low-dose adjuvant radiotherapy for high-risk prostate cancer","volume":"69","author":"MacDonald","year":"2007","journal-title":"Urology"},{"key":"ref_33","first-page":"CD007234","article-title":"Adjuvant radiotherapy following radical prostatectomy for prostate cancer","volume":"12","author":"Daly","year":"2011","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1016\/S0090-4295(99)00390-8","article-title":"Salvage cryotherapy for recurrent prostate cancer after radiation therapy: The Columbia experience","volume":"55","author":"Hayek","year":"2000","journal-title":"Urology"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"115","DOI":"10.3109\/21681805.2014.968869","article-title":"Salvage cryotherapy for local recurrence after radiotherapy for prostate cancer","volume":"49","author":"Bratt","year":"2015","journal-title":"Scand. J. Urol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"896","DOI":"10.1111\/bju.13766","article-title":"Salvage high-intensity focused ultrasound (HIFU) for locally recurrent prostate cancer after failed radiation therapy: Multi-institutional analysis of 418 patients","volume":"119","author":"Crouzet","year":"2017","journal-title":"BJU Int."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1016\/S0090-4295(00)00556-2","article-title":"Risk factors for vesicourethral anastomotic stricture after radical prostatectomy","volume":"56","author":"Borborogly","year":"2000","journal-title":"Urology"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1557","DOI":"10.1001\/jama.2009.1451","article-title":"Comparative effectiveness of minimally invasive vs open radical prostatectomy","volume":"302","author":"Hu","year":"2009","journal-title":"JAMAA"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"957","DOI":"10.1111\/j.1464-410X.2008.08278.x","article-title":"An analysis of the causes of bladder neck contracture after open and robot-assisted laparoscopic radical prostatectomy","volume":"103","author":"Webb","year":"2009","journal-title":"BJU Int."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"803","DOI":"10.1016\/j.eururo.2011.12.020","article-title":"Temporal national trends of minimally and retropubic radical prostatectomy outcomes from 2003 to 2007: Results from the 100% Medicare sample","volume":"61","author":"Kowalczyk","year":"2012","journal-title":"Eur. Urol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1111\/j.1464-410X.2003.04668.x","article-title":"Can leakage at the vesico-urethral anastomosis be predicted after radical retropubic prostatectomy?","volume":"93","author":"Ramsden","year":"2004","journal-title":"BJU Int."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1649","DOI":"10.1016\/j.juro.2014.11.102","article-title":"Total bladder and posterior urethral reconstruction: Salvage technique for defunctionalized bladder with recalcitrant posterior urethral stenosis","volume":"193","author":"Patil","year":"2015","journal-title":"J. Urol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"435","DOI":"10.7326\/0003-4819-148-6-200803180-00209","article-title":"Systematic review: Comparative effectiveness and harms of treatment for clinically localized prostate cancer","volume":"148","author":"Wilt","year":"2008","journal-title":"Ann. Intern. Med."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"528","DOI":"10.1016\/j.eururo.2008.06.059","article-title":"Adjuvant radiotherapy for patients with locally advanced prostate cancer\u2014A new standard?","volume":"58","author":"Ganswindt","year":"2008","journal-title":"Eur. Urol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"956","DOI":"10.1016\/j.juro.2008.11.032","article-title":"Adjuvant radiotherapy for pathological T3N0M0 prostate cancer significantly reduces risk of metastases and improves survival: Long-term followup of a randomized clinical trial","volume":"181","author":"Thompson","year":"2009","journal-title":"J. Urol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"360","DOI":"10.1634\/theoncologist.2009-S104","article-title":"Radioprotectors and mitigators of radiation-induced normal tissue injury","volume":"15","author":"Citrin","year":"2010","journal-title":"Oncologist"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1016\/S0167-8140(96)01880-4","article-title":"Wound healing following radiation therapy: A review","volume":"42","author":"Tibbs","year":"1997","journal-title":"Radiother. Oncol."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"103","DOI":"10.3857\/roj.2014.32.3.103","article-title":"Mechanism of radiation-induced normal tissue toxicity and implications for future clinical trials","volume":"32","author":"Kim","year":"2014","journal-title":"Radiat. Oncol. J."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1307","DOI":"10.1016\/j.juro.2013.10.147","article-title":"Outcomes after urethroplasty for radiotherapy induced bulbomembranous urethral stricture disease","volume":"191","author":"Hofer","year":"2014","journal-title":"J. Urol."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"2669","DOI":"10.1007\/s00345-020-03446-y","article-title":"A multi-institutional critical assessment of dorsal onlay urethroplasty for post-radiation urethral stenosis","volume":"39","author":"Policastro","year":"2021","journal-title":"World J. Urol."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"635060","DOI":"10.3389\/fsurg.2021.635060","article-title":"Current management of membranous urethral strictures due to radiation","volume":"8","author":"Waterloos","year":"2021","journal-title":"Front. Surg."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"461","DOI":"10.1016\/S0360-3016(01)01811-9","article-title":"The dosimetry of prostate brachytherapy-induced urethral strictures","volume":"52","author":"Merrick","year":"2002","journal-title":"Int. J. Radiat. Oncol. Biol. Phys."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"1376","DOI":"10.1016\/S0022-5347(05)00681-6","article-title":"Risk factors for the development of prostate brachytherapy related urethral strictures","volume":"175","author":"Merrick","year":"2006","journal-title":"J. Urol."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1097\/COC.0b013e3182546821","article-title":"Is there an increase in genitourinary toxicity in patients treated with transurethral resection of the prostate and radiotherapy? A systematic review","volume":"37","author":"Ishiyama","year":"2014","journal-title":"Am. J. Clin. Oncol."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"1597","DOI":"10.1016\/0360-3016(86)90283-X","article-title":"The effect of prior transurethral resection of the prostate on post radiation urethral strictures and bladder neck contractures","volume":"12","author":"Seymore","year":"1986","journal-title":"Int. J. Radiat. Oncol. Biol. Phys."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"1233","DOI":"10.1001\/jama.294.10.1233","article-title":"Comparison of conventional-dose vs high-dose conformational radiation therapy in clinically localized adenocarcinoma of the prostate: A randomized controlled trial","volume":"294","author":"Zietman","year":"2005","journal-title":"JAMA"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"3904","DOI":"10.1200\/JCO.2000.18.23.3904","article-title":"Preliminary results of a randomized radiotherapy dose- escalation study comparing 70 Gy with 78 Gy for prostate cancer","volume":"18","author":"Pollack","year":"2000","journal-title":"J. Clin. Oncol."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"1124","DOI":"10.1016\/j.ijrobp.2007.11.044","article-title":"Incidence of late rectal and urinary toxicities after three-dimensional conformal radiotherapy and intensity-modulated radiotherapy for localized prostate cancer","volume":"70","author":"Zelefsky","year":"2008","journal-title":"Int. J. Radiat. Oncol. Biol. Phys."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1016\/j.urolonc.2013.09.004","article-title":"Optimal timing of early versus delayed adjuvant radiotherapy following radical prostatectomy for locally advanced prostate cancer","volume":"32","author":"Kowalczyk","year":"2014","journal-title":"Urol. Oncol."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"1459","DOI":"10.1016\/j.juro.2015.11.072","article-title":"The patient burden of bladder outlet obstruction after prostate cancer treatment","volume":"195","author":"Lieberman","year":"2016","journal-title":"J. Urol."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1177\/153303460700600206","article-title":"Issues critical to the successful application of cryosurgical ablation of the prostate","volume":"6","author":"Baust","year":"2007","journal-title":"Technol. Cancer Res. Treat."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"S59","DOI":"10.1016\/j.urology.2013.08.036","article-title":"SIU\/ICUD consultation on urethral strictures: Posterior urethral stenosis after treatment of prostate cancer","volume":"83","author":"Herschorn","year":"2014","journal-title":"Urology"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"187","DOI":"10.3816\/CGC.2005.n.031","article-title":"Prostate cancer therapy with high-intensity focused ultrasound","volume":"4","author":"Gardner","year":"2005","journal-title":"Clin. Genitourin. Cancer"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"590","DOI":"10.1259\/bjr\/17150274","article-title":"High intensity focused ultrasound: Surgery of the future?","volume":"76","author":"Kennedy","year":"2003","journal-title":"Br. J. Radiol."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"2005","DOI":"10.1016\/j.juro.2008.07.038","article-title":"Radiation therapy for prostate cancer increases subsequent risk of bladder and rectal cancer: A population-based cohort study","volume":"180","author":"Nieder","year":"2008","journal-title":"J. Urol."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"734","DOI":"10.1159\/000020371","article-title":"Abdomino-perineal repair of recurrent and complex bladder neck-prostatic urethra contractures","volume":"38","author":"Theodorus","year":"2000","journal-title":"Eur. Urol."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"1199","DOI":"10.1016\/j.urology.2007.02.066","article-title":"S-shaped coaxial dilators for male urethral strictures","volume":"69","author":"Herschorn","year":"2007","journal-title":"Urology"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"611","DOI":"10.1016\/0002-9610(84)90124-7","article-title":"Coaxial balloon dilatation and calibration of urethral strictutres","volume":"147","author":"Giesy","year":"1984","journal-title":"Am. J. Surg."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"1000","DOI":"10.1016\/S0090-4295(99)80121-6","article-title":"Incontinence and vesical neck strictures following radical retropubic prostatectomy","volume":"45","author":"Geary","year":"1995","journal-title":"Urology"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"742","DOI":"10.1016\/S0090-4295(00)01048-7","article-title":"Anastomotic strictures following radical prostatectomy: Insights into incidence, effectiveness of intervention, effect on continence, and factors predisposing to occurrence","volume":"57","author":"Park","year":"2001","journal-title":"Urology"},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"755","DOI":"10.1016\/S0022-5347(17)40082-6","article-title":"Anastomotic strictures following radical prostatectomy: Risk factors and management","volume":"143","author":"Surya","year":"1990","journal-title":"J. Urol."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1016\/S0022-5347(01)66595-9","article-title":"Endoscopic evaluation and treatment of anastomotic strictures after raical retropubic prostatectomy","volume":"155","author":"Dalkin","year":"1996","journal-title":"J. Urol."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"446","DOI":"10.1016\/j.urology.2012.04.036","article-title":"Pubovesical fistula: A rare complication after treatment of prostate cancer","volume":"80","author":"Matsushita","year":"2012","journal-title":"Urology"},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1016\/j.urology.2017.12.020","article-title":"Urosymphyseal fistulas resulting from endoscopic treatment of radiation-induced posterior urethral strictures","volume":"114","author":"Shapiro","year":"2018","journal-title":"Urology"},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"382","DOI":"10.1159\/000019620","article-title":"Anastomotic stricture following radical prostatectomy. Incidence, findings, and treatment","volume":"33","author":"Popken","year":"1998","journal-title":"Eur. Urol."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"875","DOI":"10.1089\/end.2012.0661","article-title":"Transrectal ultrasonography-guided injection of long-acting steroids in the treatment of recurrent\/resistant anastomotic stenosis after radical prostatectomy","volume":"27","author":"Kravchick","year":"2013","journal-title":"J. Endourol."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"796","DOI":"10.1111\/j.1464-410X.2008.07919.x","article-title":"Management of recurrent anastomotic stenosis following radical prostatectomy using holmium laser and steroid injection","volume":"102","author":"Eltahawy","year":"2008","journal-title":"BJU Int."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"587","DOI":"10.1016\/j.juro.2014.08.104","article-title":"Intralesional injection of mitomycin C at transurethral incision of bladder neck contracture may offer limited benefit: TURNS Study Group","volume":"193","author":"Redshaw","year":"2015","journal-title":"J. Urol."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"672.e15","DOI":"10.1016\/j.urolonc.2017.07.031","article-title":"Mitomycin-C and urethral dilatation: A safe, effective, and minimally invasive procedure for recurrent vesicourethral anastomotic stenoses","volume":"35","author":"Sourial","year":"2017","journal-title":"Urol. Oncol."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1016\/j.juro.2011.03.019","article-title":"Radial urethrotomy and intralesional mitomycin C for the management of recurrent bladder neck contractures","volume":"186","author":"Vanni","year":"2011","journal-title":"J. Urol."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1016\/j.urpr.2014.12.007","article-title":"Durable Results of Mitomycin C Injection with Internal Urethrotomy for Refractory Bladder Neck Contractures: Multi-institutional Experience","volume":"2","author":"Nagpal","year":"2015","journal-title":"Urol. Pract."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"1494","DOI":"10.1016\/j.urology.2015.02.050","article-title":"Visual Internal Urethrotomy with Intralesional Mitomycin C and Short-term Clean Intermittent Catheterization for the Management of Recurrent Urethral Strictures and Bladder Neck Contractures","volume":"85","author":"Farrell","year":"2015","journal-title":"Urology"},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"758536","DOI":"10.1155\/2015\/758536","article-title":"Bipolar Transurethral Incision of Bladder Neck Stenoses with Mitomycin C Injection","volume":"2015","author":"Lyon","year":"2015","journal-title":"Adv. Urol."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1007\/s11934-015-0536-4","article-title":"Management strategies for Post-Prostatectomy Bladder Neck Contractures","volume":"16","author":"Kovell","year":"2015","journal-title":"Curr. Urol. Rep."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"580","DOI":"10.21037\/tau.2018.04.04","article-title":"Posterior urethral stenosis after prostate cancer treatment: Contemporary options for definitive management","volume":"7","author":"Kahokehr","year":"2018","journal-title":"Transl. Androl. Urol."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1097\/00005392-200102000-00014","article-title":"Combined stent and artificial urinary sphincter placement for management of severe recurrent bladder neck contracture and stress incontinence after prostatectomy: A long-term evaluation","volume":"16","author":"Elliott","year":"2001","journal-title":"J. Urol."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"933","DOI":"10.1016\/j.urology.2013.06.017","article-title":"The UroLume stent revisited: The Duke experience","volume":"82","author":"McNamara","year":"2013","journal-title":"Urology"},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"198","DOI":"10.1016\/j.juro.2010.09.020","article-title":"Management for prostate cancer treatment related posterior urethral and bladder neck stenosis with stents","volume":"185","author":"Erickson","year":"2011","journal-title":"J. Urol."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"1839","DOI":"10.1111\/j.1464-410X.2011.10230.x","article-title":"Long-term results of permanent urethral stent Memotherm implantation in the management of recurrent bulbar urethral stenosis","volume":"108","author":"Sertcelik","year":"2011","journal-title":"BJU Int."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"S31","DOI":"10.1016\/j.urology.2013.09.012","article-title":"SIU\/ICUD Consultation on Urethral Strictures: The management of anterior urethral stricture disease using substitution urethroplasty","volume":"83","author":"Chapple","year":"2014","journal-title":"Urology"},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1007\/s11884-016-0355-6","article-title":"The devastated bladder outlet in cancer survivors after local therapy for prostate cancer","volume":"11","author":"Sukumar","year":"2016","journal-title":"Curr. Bladder Dysfunct. Rep."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"2147","DOI":"10.1007\/s11255-014-0816-9","article-title":"Open reconstruction of recurrent vesicourethral anastomotic st2icture after radical prostatectomy","volume":"46","author":"Nikolavsky","year":"2014","journal-title":"Int. Urol. Nephrol."},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1016\/j.urology.2018.05.007","article-title":"Patency and incontinence rates after robotic bladder neck reconstruction for vesicourethral anastomotic stenosis and recalcitrant bladder neck contractures: The Trauma and Urologic Reconstructive Network of Surgeons experience","volume":"118","author":"Kirshenbaum","year":"2018","journal-title":"Urology"},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"1373","DOI":"10.1016\/S0022-5347(01)62540-0","article-title":"Obliterative vesicourethral strictures following radical prostatectomy for prostate cancer: Reconstructive armamentarium","volume":"160","author":"Wessells","year":"1998","journal-title":"J. Urol."},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"2508","DOI":"10.1016\/j.juro.2006.07.152","article-title":"Management of severe urethral complications of prostate cancer therapy","volume":"176","author":"Elliott","year":"2006","journal-title":"J. Urol."},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1016\/j.urology.2015.02.073","article-title":"Postprostatectomy anastomosis: A systematic review","volume":"86","author":"Song","year":"2015","journal-title":"Urology"},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"1944","DOI":"10.1016\/j.juro.2011.07.040","article-title":"Open retropubic reanastomosis for highly recurrent and complex bladder neck stenosis","volume":"186","author":"Pfalzgraf","year":"2011","journal-title":"J. Urol."},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"1885","DOI":"10.1007\/s00345-017-2067-8","article-title":"Transperineal reanastomosis for treatment of highly recurrent anastomotic strictures after radical retropubic prostatectomy: Extended follow-up","volume":"35","author":"Schuettfort","year":"2017","journal-title":"World J. Urol."},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"702","DOI":"10.1016\/j.urology.2014.04.023","article-title":"Urinary diversions after radiation for prostate cancer: Indications and treatment","volume":"84","author":"Faris","year":"2014","journal-title":"Urology"},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"1761","DOI":"10.1016\/j.juro.2010.12.038","article-title":"Urethroplassty for radiatiotherapy induced bulbomembranous strictures: A multi-institutional experience","volume":"185","author":"Meeks","year":"2011","journal-title":"J. Urol."},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"1402","DOI":"10.1016\/j.urology.2011.11.077","article-title":"Urethroplasty after radiation therapy for prostate cancer","volume":"79","author":"Glass","year":"2012","journal-title":"Urology"},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1007\/s00345-015-1608-2","article-title":"Observations, and outcomes of urethroplasty for bulbomembranous stenosis after radiation therapy for prostate cancer","volume":"34","author":"Rourke","year":"2016","journal-title":"World J. Urol."},{"key":"ref_103","unstructured":"Lumen, N., Campos-Juanatey, F., Dimitropoulos, K., Greenwell, T., Martins, F.E., Osman, N., Riechardt, S., Waterloos, M., Barratt, R., and Chan, G. (2021). Non-traumatic posterior urethral strictures. EAU Guidelines on Urethral Strictures, EAU Guidelines Office."},{"key":"ref_104","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1016\/j.juro.2015.03.116","article-title":"Outcomes of Ventral Onlay Buccal Mucosa Graft Urethroplasty in Patients after Radiotherapy","volume":"194","author":"Ahyai","year":"2015","journal-title":"J. Urol."},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"1771","DOI":"10.1016\/S0022-5347(05)67539-8","article-title":"Salvage prostatectomy with continent catheterizable urinary reconstruction: A novel approach to recurrent prostate cancer after radiation therapy","volume":"163","author":"Pisters","year":"2000","journal-title":"J. Urol."},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"2200","DOI":"10.1016\/j.juro.2007.01.151","article-title":"Salvage prostatectomy with bladder neck closure, continent catheterizable stoma and bladder augmentation: Feasibility and patient reported continence outcomes at 32 months","volume":"177","author":"De","year":"2007","journal-title":"J. Urol."},{"key":"ref_107","doi-asserted-by":"crossref","first-page":"1185","DOI":"10.1016\/j.urology.2009.11.070","article-title":"Last resort in devastated bladder outlet: Bladder neck closure and continent vesicostomy--long-term results and comparison of different techniques","volume":"75","author":"Spahn","year":"2010","journal-title":"Urology"},{"key":"ref_108","first-page":"70","article-title":"Cystectomy and Urinary Diversion for the Management of a Devastated Lower Urinary Tract Following Prostatic Cryotherapy and\/or Radiotherapy","volume":"115","author":"Sack","year":"2016","journal-title":"WMJ"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/10\/21\/4920\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T07:22:32Z","timestamp":1760167352000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/10\/21\/4920"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,10,24]]},"references-count":108,"journal-issue":{"issue":"21","published-online":{"date-parts":[[2021,11]]}},"alternative-id":["jcm10214920"],"URL":"https:\/\/doi.org\/10.3390\/jcm10214920","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,10,24]]}}}