What is your initial endoscopic treatment for BNC post-BPH surgery? Please comment below. 66y, PVP 1 year ago Recurrent voiding symptoms Cystoscopy:

He has 2 strictures, the One before the sphincter is also a problem + BNContracture. Deep incision with Holmium or cautery (5-6-7oclock) + steroids and be sure there is no bacteria pryor or afterwards.

The most studied drug is mitomycin C after deep transurethral incisions. You may try at least 3 endoscopic surgeries before offer recon surgery. There is a new transurethral technique that promises great results described by @drjnwarner. Greetings Dr.

Bladder neck resection plus incision from the ureteral orifis to verru. İntravesical Mitomycin if available followed by a weekly scheme as for Bladder cancer..

If I have healthy tissu in endorectal ultrasound I would try complementary Holep if Holep wasn't performed before by @fgomsan 😉 Otherwise Bladder Neck Incision with injection of corticoides. Optilume is not adapted yet for the size of the bladder neck.

Bladder Neck remodelation with Holmium Laser. If is possible Triamcinolone o Mitomicina C. 5-7 position. Silicon catheter 16 french. Montelukasts 10mg for 3 months

I would check for signs of #DU #hypocontractility. That will be an additional #risk factor for another stenosis. highest risk for another is stenosis itself. My only tip is - do not incise, just resect. If one opens extraprostatic space, urine extra will course more inflammation

It is possible to incise it until you find healthy tissue without opening the extra-prostatic space. The advantage of incisions over resection are the mucosal bridges between them, instead of another circular defect. It may speed up the epitelization like hemorrhoidectomy.

Not sure it matters much. No XRT like in some of the prostate cancer patients I would either resect or lateral incisions (deep) with holmium or cautery. Some using Optilume for this.

Laser incision plus low dose corticosteroids and colchicine

looks like there is a moderate amount of anterior tissue that i would resect as well as deep incisions at 3 and 9 oclock