The United States Preventive Services Task Force (USPSTF) is the most widely regarded source for information on US cancer screening. In 2012, the USPSTF gave prostate cancer screening a grade “D” recommendation, essentially guiding physicians and patients to discourage prostate cancer early detection.1 This recommendation may have had an adverse effect on prostate cancer incidence rates across risk groups, including potentially lethal cancers, and was widely decried by specialty and advocacy groups.2 The grade D recommendation was based on what is now known to be an incorrect interpretation of the clinical evidence supporting screening at the time and legitimate concerns about cancer overdetection and overtreatment (the detection and treatment of indolent cancers that would not have been a problem if left undiagnosed and untreated)

We present preliminary results of a case series on refractory bladder neck contracture (BNC) treated with robot-assisted laparoscopic Y-V plasty (RAYV). Between 01/2013 and 02/2016, 12 consecutive adult male patients underwent RAYV in our hospital. BNC developed after transurethral procedures (n = 9), simple prostatectomy (n = 2) and HIFU therapy of the prostate (n = 1). Each patient had had multiple unsuccessful previous endoscopic treatments. All RAYV procedures were performed using a transperitoneal six-port approach (four-arm robotic setting). There were no intraoperative or major postoperative complications. During a median follow-up of 23.2 months two cases of refractory BNC were observed. In both cases a postoperative International Prostate Symptom Score (IPSS) of 20 and 25 was reported, respectively. In contrast,amongst the patients without evidence of refractory BNC the median IPSS was 6.5 reflecting an only mildly impaired voiding function in most cases, thus, suggesting a treatment success in 83.3% of patients. To the best of our knowledge,this is the first report on RAYV for refractory BNC. In our series RAYV was feasible in all patients, and only two cases of refractory BNC were reported during a median follow-up of almost 2 years. At the same time, no intraoperative or major postoperative complications were observed. More clinical data with a longer follow-up are needed in this promising field to reveal the actual efficacy and relevance of RAYV

The United States Preventive Services Task Force (USPSTF) is the most widely regarded source for information on US cancer screening. In 2012, the USPSTF gave prostate cancer screening a grade “D” recommendation, essentially guiding physicians and patients to discourage prostate cancer early detection.1 This recommendation may have had an adverse effect on prostate cancer incidence rates across risk groups, including potentially lethal cancers, and was widely decried by specialty and advocacy groups.2 The grade D recommendation was based on what is now known to be an incorrect interpretation of the clinical evidence supporting screening at the time and legitimate concerns about cancer overdetection and overtreatment (the detection and treatment of indolent cancers that would not have been a problem if left undiagnosed and untreated)

We present preliminary results of a case series on refractory bladder neck contracture (BNC) treated with robot-assisted laparoscopic Y-V plasty (RAYV). Between 01/2013 and 02/2016, 12 consecutive adult male patients underwent RAYV in our hospital. BNC developed after transurethral procedures (n = 9), simple prostatectomy (n = 2) and HIFU therapy of the prostate (n = 1). Each patient had had multiple unsuccessful previous endoscopic treatments. All RAYV procedures were performed using a transperitoneal six-port approach (four-arm robotic setting). There were no intraoperative or major postoperative complications. During a median follow-up of 23.2 months two cases of refractory BNC were observed. In both cases a postoperative International Prostate Symptom Score (IPSS) of 20 and 25 was reported, respectively. In contrast,amongst the patients without evidence of refractory BNC the median IPSS was 6.5 reflecting an only mildly impaired voiding function in most cases, thus, suggesting a treatment success in 83.3% of patients. To the best of our knowledge,this is the first report on RAYV for refractory BNC. In our series RAYV was feasible in all patients, and only two cases of refractory BNC were reported during a median follow-up of almost 2 years. At the same time, no intraoperative or major postoperative complications were observed. More clinical data with a longer follow-up are needed in this promising field to reveal the actual efficacy and relevance of RAYV