A South Florida First: DSUI Surgeon Offers Minimally Invasive Bladder Neck Contracture Treatment
Summary
- Reconstructive urologist Dr. Laura Horodyski trained with the Mayo Clinic’s Dr. Nick Warner, who pioneered transurethral incision with transverse mucosal realignment surgery.
- Dr. Horodyski is now the first surgeon to offer the procedure in South Florida.
- The minimally invasive option replaces the need for major open or robotic surgeries aimed at treating bladder neck contracture.
Laura Horodyski, M.D., a reconstructive urologist at Desai Sethi Urology Institute (DSUI) and assistant professor of urology at the University of Miami Miller School of Medicine, is the first surgeon in South Florida to offer transurethral incision with transverse mucosal realignment, a minimally invasive procedure shown to successfully treat nearly 90% of patients with bladder neck contracture and vesicourethral anastomotic stenosis with the first surgery.
Dr. Horodyski, who trained with Mayo Clinic urologist Nick Warner, M.D., is one of about 26 urologic surgeons nationwide who have trained in and are performing the procedure.
“We have not had great treatment options for people with bladder neck contracture, which causes significant quality-of-life issues. Patients either got repetitive incisions and dilations or they would go through a major, open or robotic surgery that would take six to eight hours and had a very challenging recovery,” Dr. Horodyski said. “I see a lot of these patients and wanted to offer them something that would be definitive and less invasive. This approach appears to be a simple solution for a complex problem.”
Successful Outcomes with No Major Surgical Complications
In a retrospective review, researchers studied 19 patients with a median follow-up of six months and found success in 89% of patients after one procedure and 100% in those who needed a second procedure.
“One of our goals at DSUI is to push the field of urology forward and to be among the first in the nation to offer patients the best and most up-to-date types of care,” said Dipen J. Parekh, M.D., DSUI’s founding director and chief operating officer at UHealth—the University of Miami Health System. “Transurethral incision with transverse mucosal realignment surgery checks boxes for safety and effectiveness for solving a distressing quality-of-life issue. We applaud Dr. Horodyski for pursuing the training and bringing this to DSUI.”
Patients generally go home the day of surgery. Surgeons perform the technique through a camera inserted through the urethra, so there are no external incisions. Patients have a catheter for three to five days and have a follow-up procedure three to four months later to make sure the sutures have dissolved.
“We use a special type of suturing tool that was adopted for use in urology through a special sheath that Dr. Warner designed,” Dr. Horodyski said.
Collaboration Amongst Colleagues
Dr. Horodyski also offers a drug-coated balloon procedure for these conditions, called Optilume. She noted that the procedure by Dr. Warner has more extensive published data for use in bladder neck contracture.
“The urologists who have trained in transurethral incision with transverse mucosal realignment plan to pool our data and publish outcomes studies in the future,” Dr. Horodyski said. “This will allow us to fully understand the ins and outs of the procedure and help guide our recommendations when we evaluate patients with this condition.”
Tags: Department of Urology, Desai Sethi Urology Institute, Dr. Laura Horodyski, urology