Abstract
BACKGROUND AND OBJECTIVE: Refractory bladder neck contracture (BNC) poses significant challenges after transurethral resection of the prostate. This study compares laparoscopic bladder neck wedge resection with posterior urethral bed preservation (LCBNRE) versus transurethral resection of the bladder neck (TURBN) in managing refractory BNC. METHODS: A retrospective analysis was conducted of 103 patients (2018-2023) divided into the LCBNRE (n = 58) and TURBN (n = 45) groups. Outcomes included operative parameters, urodynamics, International Prostate Symptom Score, and recurrence rates. KEY FINDINGS AND LIMITATIONS: LCBNRE showed longer operative time (100 vs 43 min, p < 0.01) but lower 30-d reoperation (1.7% vs 31.1%, p < 0.01) and recurrence (5.2% vs 28.9%, p = 0.01) rates. Urodynamic improvements favored LCBNRE (p < 0.01). Limitations include single-center design and short follow-up. CONCLUSIONS AND CLINICAL IMPLICATIONS: LCBNRE is more effective for refractory BNC, with durable outcomes. Multicenter randomized trials are needed for validation. PATIENT SUMMARY: This study compared two surgical methods for bladder neck scarring. The laparoscopic approach resulted in better urine flow, fewer repeat surgeries, and lower recurrence rates than traditional methods.