To evaluate the effi cacy of nephrostomy balloon dilation (NBD) for patients who developed vesicourethral anastomotic stricture (VAS)
following radical prostatectomy. NBD was performed in patients who developed VAS following radical prostatectomy. Quality of
life (QoL), International Prostate Symptom Score (IPSS) and maximal urinary fl ow rate (Qmax) were evaluated. Four hundred and
sixty-three prostate cancer patients underwent radical retropubic prostatectomy (RRP), and 86 underwent laparoscopic radical
prostatectomy (LRP). Most patients (90.3%) had T2 or T3 prostate cancer and a pathological Gleason score of ≤ 7. Forty-fi ve (8.2%)
and four (4.7%) patients developed VAS due to radical or LRP, respectively. Forty (89%) patients underwent NBD, including three
cases of repeat dilation. The median Qmax was 4 ml s−1 (interquartile range (IQR), 2.3-5.6) before dilation and improved to 16 ml s−1
(IQR, 15–19) and 19 ml s−1 (IQR, 18-21) at the 1- and 12-month follow-up, respectively (P < 0.01). Fifteen (37.5%) patients had
urinary incontinence prior to dilation, whereas only three (7.5%) patients had incontinence 12 months following dilation (P < 0.01).
The median IPSS score improved from 19 (IQR, 17–24) before dilation to 7 (IQR, 6–8) at 12 months following dilation, and the
QoL score improved from 5 (IQR, 4–6) before dilation to 2 (IQR, 2–3) at 12 months following dilation (P < 0.01 in both). VAS
occurs in a small but signifi cant proportion of patients following radical prostatectomy. NBD offers an effective remedy for VAS.

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