Long-Term outcomes of subtrigonal inlay patch in case series – Buccal mucosal graft technique for recurrent bladder neck stenosis

Refractory bladder neck stenosis is a challenging entity for both clinicians and patients. We aimed to present our long-term results of subtrigonal inlay patch (SIP-BMG) technique via open approach that we previously described for refractory bladder neck stenosis (BNS). All 11 patients operated for recurrent BNS between 2019 and 2023 with SIP technique were retrospectively included. Demographic data, history of previous endourethral treatment, pre-operative voiding status and postoperative follow-up results were analysed. Patient evaluation in each visit included IPSS and OAB-V8 scores, uroflowmetry and questioning of adverse effects. Recurrence was defined as the need for any intervention for BNS on follow-up. Transurethral prostate surgery was the most common cause and all patients had at least two previous endourological operation for BNS. The median operative time was 88 min (60–170) and no intraoperative complications were observed. All postoperative complications were Clavien-Dindo grade 1–2. All patients were able to void on their first attempt after catheter removal. Average increase in Qmax at last-visit was 13.73 ml/sec and average improvement in IPSS and OAB-V8 scores was 19.90 and 10.4 respectively. De-novo urinary incontinence was reported in one patient and one patient required re-intervention for BNS on follow-up. Recurrent BNS is a challenging problem for both clinicians and patients, especially when it becomes refractory to endourologic interventions. The present study demonstrates durable and promising success after SIP technique for recurrent BNS in long term follow-up. However, these results should be interpreted with caution and further prospective trials with larger patient cohorts are required.