Scar resection
The resectoscope is inserted through the urethra, the scar ring of the cervix is resected around the circumference to healthy tissue, especially carefully in the 5–7 o’clock zone, where the narrowing is usually most pronounced; the bed coagulates. The removed tissue is sent for histology - this is important after a TUR of prostate cancer or if a tumor is suspected. A catheter is installed for 2–3 days. Resection provides a wider and more durable lumen than simple incision, with a slightly greater risk of incontinence, and is therefore performed by an experienced endourologist.
Bladder neck sclerosis
Sclerosis (contracture) of the cervix is a cicatricial narrowing of the outlet of the bladder, which develops after TUR or adenomectomy (5–10% of cases), chronic prostatitis, and sometimes is congenital (Marion’s disease). It manifests itself as a weak stream, straining, residual urine and relapses of infection with a normal prostate according to ultrasound. The diagnosis is confirmed by urethrocystoscopy. Treatment is endoscopic dissection or scar resection.
Recovery and results
After removing the catheter, the flow is restored immediately. A burning sensation and blood may appear within 1–2 weeks. The effectiveness of the first operation is 80–90%; in case of relapse, re-dissection with the introduction of anti-scarring drugs or wider resection is performed. Control - uroflowmetry after 1 and 3 months.
