scholarly journals Sachse Laser in post-trauma urethral stricture. A valid alternative before urethroplasty.

2018 ◽  
Vol 2 (2) ◽  
Author(s):  
Astrit Mustafa ◽  
Evisa Zhapa ◽  
Francesco Saverio Grossi
Keyword(s):  
Urethral Stricture ◽  
Holmium Laser ◽  
Internal Urethrotomy ◽  
Urethral Strictures ◽  
Before And After ◽  
Cold Knife ◽  
Multiple Treatments ◽  
Voided Volume

Background: The most commonly used treatment modality for urethral strictures is the direct visual internal urethrotomy method according Sachse cold knife, but with low long-term success rate. Alternative method after failure is isurethroplasty with preputial flap or Buccal mucosa. The aim of this presentation is to report the efficacy of the Internal Urethrotomy with Holmium Laser (Sachse laser).Material and methods: We report three cases of urethral stenosis after trauma which treated with Internal Urethrotomy with Holmium Laser (Sachse laser) after failure of multiple treatments with Sachse cold knife. We evaluated and compared the uroflowmetry parameters before and after Sachse laser.Results: The average of uroflowmetry parameters before incision were: Q max 4.5 ml/sec, Q med 3 ml/sec. Voided Volume 323 cc, while after incision with Sachse laser were: Q max 30 ml/sec, Q med 12 ml/sec. Voided Volume 363 cc.No patients relapsed during follow-up time from 3 to 24 months.Conclusion: Even though these are only a few cases, we think that Sachse laser is a valid alternative after unsuccessful Sachse cold knife and before Urethroplasty, even in patients with urethral stricture after trauma.

Evaluation of Holmium Laser versus Cold Knife in Optical Internal Urethrotomy for the Management of Urethral Stricture

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Wael Ali Maged ◽  
Mohamed Ahmed Gamal ◽  
Samuel Fayek Tawfeles
Keyword(s):  
Urethral Stricture ◽  
Treatment Effectiveness ◽  
Holmium Laser ◽  
Military Hospital ◽  
University Hospitals ◽  
Internal Urethrotomy ◽  
Cold Knife ◽  
Group 10 ◽  
Optical Internal Urethrotomy

Abstract Background : urethral stricture is one of the most difficult urological problems to cure adequately and is know to mankind since ages as it has been documented in ancient literature of Egyptians and Greeks. Aim of the work: the aim of our study is to evaluate and compare the outcomes of Ho:YAG laser urethrotomy with the conventional cold knife technique as regards treatment outcome, efficacy and complications Patients and methods: A total of 20 male patients presented to the urology department at El Maadi military hospital and Ain shams university hospitals diagnosed as urethral stricture requiring optical internal urethrotomy were included in this study. Patients were randomized into two groups : In group A (holmium group): 10 patients underwent internal urethrotomy with Holmium laser. In group B (cold knife group) 10 patients underwent internal urethrotomy with cold knife. Results: based upon uroflowmetry, assessment of treatment effectiveness and complications were made at 3 months follow-up. Post operative fall in the peak flow rate was noted during the follow up in both groups, but was highter fall in the holmium group than the cold knife group at the end of the third month.

scholarly journals Holmium laser vs. conventional (cold knife) direct visual internal urethrotomy for short-segment bulbar urethral stricture: Outcome analysis

2016 ◽  
Vol 10 (5-6) ◽  
pp. 161 ◽  
Author(s):  
Ankur Jhanwar ◽  
Manoj Kumar ◽  
Satya Narayan Sankhwar ◽  
Gaurav Prakash
Keyword(s):  
Urethral Stricture ◽  
Operating Time ◽  
Holmium Laser ◽  
Outcome Analysis ◽  
Internal Urethrotomy ◽  
Short Segment ◽  
Urethral Strictures ◽  
Group A ◽  
Cold Knife ◽  
Group B

Introduction: Our goal was to analyze the outcome between holmium laser and cold knife direct visual internal urethrotomy (DVIU) for short-segment bulbar urethral stricture.Methods: We conducted a prospective study comprised of 112 male patients seen from June 2013 to December 2014. Inclusion criterion was short-segment bulbar urethral stricture (≤1.5cm). Exclusion criteria were prior intervention/urethroplasty, pan-anterior urethral strictures, posterior stenosis, urinary tract infection, and those who lost to followup. Patients were divided into two groups; Group A (n=58) included cold knife DVIU and group B (n=54) included holmium laser endourethrotomy patients. Patient followup included uroflowmetry at postoperative Day 3, as well as at three months and six months.Results: Baseline demographics were comparable in both groups. A total of 107 patients met the inclusion criteria and five patients were excluded due to inadequate followup. Mean stricture length was 1.31 ± 0.252 cm (p=0.53) and 1.34 ± 0.251 cm in Groups A and B, respectively. Mean operating time in Group A was 16.3 ± 1.78 min and in Group B was 20.96 ± 2.23 min (p=0.0001). Five patients in Group A had bleeding after the procedure that was managed conservatively by applying perineal compression. Three patients in Group B had fluid extravasation postoperatively. Qmax (ml/s) was found to be statistically insignificant between the two groups at all followups.Conclusions: Both holmium laser and cold knife urethrotomy are safe and equally effective in treating short-segment bulbar urethral strictures in terms of outcome and complication rate. However, holmium laser requires more expertise and is a costly alternative.

scholarly journals Holmium: YAG Versus Cold Knife Internal Urethrotomy in the Management of Short Urethral Strictures: A Randomized Controlled Trial

2021 ◽  
Vol 12 (1) ◽  
pp. e35-e35
Author(s):  
Mohamed A. Gamal ◽  
Ahmed Higazy ◽  
Samuel F. Ebskharoun ◽  
Ahmed Radwan
Keyword(s):  
Urethral Stricture ◽  
Controlled Trial ◽  
Demographic Data ◽  
Holmium Laser ◽  
Success Rates ◽  
Internal Urethrotomy ◽  
Urethral Strictures ◽  
Significant Difference ◽  
Cold Knife ◽  
Male Patients

Introduction: our study aimed to assess the safety and efficacy of Holmium: YAG laser internal urethrotomy compared to the cold knife internal urethrotomy. Methods: Eighty adult male patients presented with a urethral stricture less than 1.5 cm were included in our study; they were randomly allocated into 2 groups representing Holmium and cold knife internal urethrotomy. A careful evaluation with ascending cystourethrogram and uroflowmetry were done on all patients, and they were followed up for 1 year with uroflowmetry. Results: Each group included 40 patients sharing the same demographic data. The most common cause of a urethral stricture in both groups was iatrogenic injury. The mean operative time of the cold knife urethrotomy procedure was 10.98 ± 2.40 minutes compared to 15.43 ± 2.48 minutes in the holmium laser urethrotomy group with a highly significant difference. The results showed success rates of 90% and 80% for the holmium laser and cold knife internal urethrotomy groups respectively. The perioperative complication according to the Clavien-Dindo classification, showed no statistically significant difference in grade 1 and 2 complications. A recurrence rate with the need for redo surgery representing grade 3B complication was seen in 4 cases in the Holmium group compared to 8 cases in the cold knife group with a statistically significant difference. Conclusion: Both Holmium Laser and cold knife internal urethrotomy are an effective surgical option for the treatment of a urethral stricture less than 1.5 cm with a promising outcome after 1-year follow-up with a better success rate using the Holmium laser.

scholarly journals Severe Penile Curvature following Otis Urethrotomy

2013 ◽  
Vol 2013 ◽  
pp. 1-3
Author(s):  
Ersagun Karaguzel ◽  
Metin Gur ◽  
Dogan S. Tok ◽  
İlke O. Kazaz ◽  
Huseyin Eren ◽  
...  
Keyword(s):  
Urethral Stricture ◽  
Tunica Albuginea ◽  
High Recurrence Rate ◽  
Penile Curvature ◽  
Corpus Spongiosum ◽  
Tunica Vaginalis ◽  
Internal Urethrotomy ◽  
Urethral Catheterization ◽  
Cold Knife

Urethral stricture is a common urological pathology with a high recurrence rate after treatment. Urethral manipulations are among its main causes. In this paper, urethral stricture developed secondary to urethral catheterization and was treated with cold-knife internal urethrotomy and the Otis urethrotomy procedure. During the follow-up period, severe ventral penile curvature preventing sexual intercourse developed due to fibrosis of the corpus spongiosum and tunica albuginea of the penis. This ventral penile curvature was corrected with a separate operation using a tunica vaginalis flap harvested from the left scrotum.

scholarly journals Internal urethrotomy versus plasmakinetic energy for surgical treatment of urethral stricture

2015 ◽  
Vol 87 (2) ◽  
pp. 161 ◽  
Author(s):  
Levent Ozcan ◽  
Emre Can Polat ◽  
Alper Otunctemur ◽  
Efe Onen ◽  
Oğuz Ozden Cebeci ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Urethral Stricture ◽  
Maximum Flow ◽  
Clinical History ◽  
Internal Urethrotomy ◽  
Urethral Strictures ◽  
Cold Knife ◽  
Group 2 ◽  
Stricture Recurrence ◽  
Group 1

Purpose: we aimed to compare the longterm outcome of surgical treatment of urethral stricture with the internal urethrotomy and plasmakinetic energy. Material and Methods: 60 patients, who have been operated due to urethral stricture were enrolled in our clinic. None of the patients had a medical history of urethral stricture. The urethral strictures were diagnosed by clinical history, uroflowmetry, ultrasonography and urethrography. The patients were divided two groups. Group 1 consisted of 30 patients treated with plasmakinetic urethrotomy and group 2 comprised 30 men treated with cold knife urethrotomy. Results: There were no statistically significant differences between two groups in terms of patient age, maximum flow rate (Qmax) and quality of life score (Qol) value. A statistical difference between the two groups was observed when we compared the 3rd-month uroflowmetry results. Group 1 patients had a mean postoperative Qmax value of 16,1 ± 2,3 ml/s, whereas group 2 had a mean postoperative Qmax value of 15,1 ± 2,2 ml/s (p < 0.05). In the cold knife group, 3 of 11 (27,7%) recurrences appeared within the first 3 months, whereas in the plasmakinetic group zero recurrences appeared within the first 3 months in our study. The urethral stricture recurrence rate up to the 12 month period was statistically significant for group 1 (n = 7, 23%) compared with group 2 (n = 11, 37%) (p < 0.05). Conclusion: We believe that plasmakinetic surgery is better method than the cold knife technique for the treatment of urethral stricture.

scholarly journals Challenges in the Diagnosis and Management of Acquired Nontraumatic Urethral Strictures in Boys in Yaoundé, Cameroon

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
F. F. Mouafo Tambo ◽  
G. Fossi kamga ◽  
C. Kamadjou ◽  
L. Mbouche ◽  
A. S. Nwaha Makon ◽  
...  
Keyword(s):  
Surgical Management ◽  
Urethral Stricture ◽  
Pediatric Surgery ◽  
Tertiary Hospital ◽  
Internal Urethrotomy ◽  
Urethral Catheterization ◽  
Diagnosis And Management ◽  
Urethral Strictures ◽  
Surgery Department

Introduction. Urethral strictures in boys denote narrowing of the urethra which can be congenital or acquired. In case of acquired strictures, the etiology is iatrogenic or traumatic and rarely infectious or inflammatory. The aim of this study was to highlight the diagnostic and therapeutic difficulties of acquired nontraumatic urethral strictures in boys in Yaoundé, Cameroon.Methodology. The authors report five cases of nontraumatic urethral strictures managed at the Pediatric Surgery Department of the YGOPH over a two-year period (November 2012–November 2014). In order to confirm the diagnosis of urethral stricture, all patients were assessed with both cystourethrography and urethrocystoscopy.Results. In all the cases the urethra was inflammatory with either a single or multiple strictures. The surgical management included internal urethrotomy (n=1), urethral dilatation (n=1), vesicostomy (n=2), and urethral catheterization (n=3). With a median follow-up of 8.2 months (4–16 months) all patients remained symptoms-free.Conclusion. The authors report the difficulties encountered in the diagnosis and management of nontraumatic urethral strictures in boys at a tertiary hospital in Yaoundé, Cameroon. The existence of an inflammatory etiology of urethral strictures in boys deserves to be considered.

Visual internal urethrotomy for management of urethral strictures in boys: a comparison of short-term outcome of holmium laser versus cold knife

2018 ◽  
Vol 50 (4) ◽  
pp. 605-609 ◽  
Author(s):  
Waseem Aboulela ◽  
Mohammed S. ElSheemy ◽  
Mahmoud Shoukry ◽  
Ahmed M. Shouman ◽  
Ahmed I. Shoukry ◽  
...  
Keyword(s):  
Holmium Laser ◽  
Internal Urethrotomy ◽  
Short Term ◽  
Term Outcome ◽  
Urethral Strictures ◽  
Short Term Outcome ◽  
Cold Knife

scholarly journals Visual Internal Urethrotomy for Adult Male Urethral Stricture Has Poor Long-Term Results

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Waleed Al Taweel ◽  
Raouf Seyam
Keyword(s):  
Median Time ◽  
Urethral Stricture ◽  
Free Probability ◽  
Long Term Results ◽  
Internal Urethrotomy ◽  
Time To Recurrence ◽  
Significant Difference ◽  
Free Rate

Objective. To determine the long-term stricture-free rate after visual internal urethrotomy following initial and follow-up urethrotomies.Methods. The records of all male patients who underwent direct visual internal urethrotomy for urethral stricture disease in our hospital between July 2004 and May 2012 were reviewed. The Kaplan-Meier method was used to analyze stricture-free probability after the first, second, third, fourth, and fifth urethrotomies.Results. A total of 301 patients were included. The overall stricture-free rate at the 36-month follow-up was 8.3% with a median time to recurrence of 10 months (95% CI of 9.5 to 10.5, range: 2–36). The stricture-free rate after one urethrotomy was 12.1% with a median time to recurrence of eight months (95% CI of 7.1–8.9). After the second urethrotomy, the stricture-free rate was 7.9% with a median time to recurrence of 10 months (95% CI of 9.3 to 10.6). After the third to fifth procedures, the stricture-free rate was 0%. There was no significant difference in the stricture-free rate between single and multiple procedures.Conclusion. The long-term stricture-free rate of visual internal urethrotomy is modest even after a single procedure.

scholarly journals DIRECT VISUAL INTERNAL URETHROTOMY (DVIU) FOR UNTREATED BULBAR URETHRAL STRICTURES. A SOLUTION?

2021 ◽  
pp. 15-16
Author(s):  
Abhiyutthan Singh Jadaon ◽  
Chitra Champawat ◽  
Chandra Pal Singh
Keyword(s):  
Treatment Failure ◽  
Urethral Stricture ◽  
Cox Regression ◽  
Tertiary Care ◽  
Multivariable Analysis ◽  
Care Hospital ◽  
Internal Urethrotomy ◽  
Urethral Strictures ◽  
Alternative Approach

Introduction :Urethral stricture diseases have been treated with numerous approaches. Though open urethroplasty is considered a one-time solution [1], The direct visual internal urethrotomy (DVIU) is still considered an alternative approach in the stepladder of treatment [2,3]. Here we report our experience at a tertiary care hospital with DVIU in a homogeneous series of patients with bulbar urethral stricture who underwent strict follow-up and present a multivariable analysis of the results to identify signicant predictors of treatment failure. We wish to offer new insights into DVIU. Materials and method: We performed a retrospective analysis of patients who underwent internal urethrotomy. Patients who underwent DVIU for untreated bulbar urethral strictures with minimum follow-up of 12 months were included. Patients with traumatic stricture and stricture length >4 cm were excluded.The primary outcome was treatment failure. Multivariable Cox regression analyses by Stata v.12.0 were used to test the association between predictors:- Stricture etiology, stenosis length, preoperative maximum ow [pQmax]) and treatment failure. Results: 215 patients were included. Median follow-up was 35 months. At 5-yr follow-up the failure-free survival rate was 54.4%. On multivariable analysis pQmax was the only signicant predictor of treatment failure. Conclusions: DVIU success rate for untreated bulbar urethral strictures was signicantly associated with preoperative maximum ow rate. The patients with a pre- operative maximum ow lesser than 6 ml/s have a low probability of success and may be considered for alternative treatments such as open urethroplasty, especially when affected by long urethral strictures.

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