METHOD FOR SURGICAL CORRECTION OF RECURRENT BLADDER NECK STENOSIS Russian patent published in 2022 - IPC A61B17/00 

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to operative urology. Transurethral incision is performed endoscopically, followed by resection of the neck of the bladder, as a result of which a funnel-shaped TUR defect is formed in the prostatic part of the urethra, facing the wide part into the lumen of the bladder, and the tip towards the membranous part of the urethra. The bladder is opened longitudinally, starting an incision 4 cm above the level of the vesicoprostatic junction and continuing it to the prostatic part of the urethra so that the distal border of the incision is 1.5 cm from the tip of the prostate gland. The edges of the dissected bladder wall are stitched on the right and left at the level of the vesicoprostatic junction with sutures inserted through the anterior abdominal wall 2 cm medial and higher than the vascular lacuna on the right and left. The sutures are stretched, as a result of which the lumen of the prostatic part of the urethra opens. A mucosal flap is taken from the inner surface of the patient’s cheek, the size of which is 2.5 cm by 5 cm. Hemostasis of the bed from which the flap was taken is carried out. The flap is placed in the transverse position of the mucosa inside on the endoscopically formed TUR defect. The flap is fixed with an absorbable thread to the bladder mucosa proximally and in the area of the apex of the prostate and the seminal tubercle distally, after which it is fixed with single sutures along the entire plane of the flap to the underlying tissues of the prostatic urethra and the neck of the bladder. The fixing seams are removed from the edges of the incision of the bladder. A Foley catheter is installed. The bladder with the anterior surface of the prostate gland is sutured with a continuous suture with an absorbable thread. The tightness of the applied seam is checked. The specified continuous seam is strengthened in the event that checking it for tightness did not show a satisfactory result, achieving its tightness. The catheter is removed and self-urination is restored after 2-3 weeks.

EFFECT: method provides stable maintenance of the lumen of the prostatic urethra and the neck of the bladder in the postoperative period, adequate physiological passage of urine through the lower urinary tract and, as a result, improving the quality of life of patients diagnosed with recurrent bladder neck stenosis.

1 cl, 10 dwg, 1 ex