scholarly journals EFFECT OF URETHRAL DILATION ON ANTERIOR URETHRAL STRICTURE RECURRENCE AFTER INTERNAL URETHROTOMY IN MALES

2013 ◽  
Vol 20 (1) ◽  
Author(s):  
Edhi Hapsari ◽  
Agus Rizal AH Hamid ◽  
Arry Rodjani ◽  
Firdaoessaleh Firdaoessaleh ◽  
Danarto HR
Keyword(s):  
Urethral Stricture ◽  
Low Flow ◽  
P Value ◽  
Internal Urethrotomy ◽  
Time To Recurrence ◽  
Kaplan Meier ◽  
Dilation Group ◽  
Stricture Recurrence ◽  
Mean Time ◽  
Urethral Dilation

Objective: The aim is to evaluate the effect of urethral dilation on anterior urethral stricture recurrences after direct vision internal urethrotomy (DVIU). Material & Method: Patients were classified into 2 groups after internal urethrotomy for urethral dilation or observation. All strictures included were anterior, single, and causing partial obstruction. Urethral dilation was performed using a metal sound. This procedure was performed every 1 or 2 weeks in the first and second month after operation and then once a month for 1 year or in case of voiding complaints or low flow rate (< 10 mL/s). Follow up at least until 1 year after DVIU. Results: A total of 32 cases could be reviewed, of which are 21 had urethral dilation and 11 observation only. In the urethral dilation group, we found 4 recurrences (19%) with mean time to recurrence 10,52 months. In the observation group, we found 7 recurrent cases (63,63%) with a mean time to recurrence of 8,09 months. P value is 0,02 which means urethral dilation significantly decreased the chance of stricture recurrence. By Kaplan Meier survival analysis, urethral dilation had a better and longer time to recurrence. Conclusion: In this study, regular meatal dilation is proven to prolong the time to recurrence of an anterior urethral stricture after DVIU. Keywords: Urethral dilation, anterior urethral stricture, stricture recurrence.

443: Can Self-Calibration Prevent Urethral Stricture Recurrence Following Direct Visual Internal Urethrotomy?

2005 ◽  
Vol 173 (4S) ◽  
pp. 121-121
Author(s):  
Hari Siva Gurunadha Rao Tunuguntla ◽  
P.V.L.N. Murthy ◽  
K. Sasidharan
Keyword(s):  
Urethral Stricture ◽  
Internal Urethrotomy ◽  
Self Calibration ◽  
Stricture Recurrence

scholarly journals Intermittent Self Dilation – An Option For The Prevention of Urethral Stricture Recurrence After Filliform Follower Urethral Dilation

2018 ◽  
Vol 14 (2) ◽  
pp. 38-40
Author(s):  
N M Shrestha
Keyword(s):  
Urethral Stricture ◽  
Clinical Symptoms ◽  
Urine Test ◽  
Group A ◽  
Prospective Comparative Study ◽  
Foley’S Catheter ◽  
Group B ◽  
Stricture Recurrence ◽  
Urethral Dilation ◽  
Lower Urinary

Background: Urethral stricture and its recurrence is still a major problem in male. Several procedures are present for the treatment of the disease. Lapides introduced the concept of intermittent self dilatation (ISD) which has decreased the incidence of recurrence of urethral stricture if doing properly. The aim of the this study was to report the outcomes of ISD for the treatment of urethral stricture after Filliform follower urethral dilatation (FFUD).Method: This was a prospective comparative study, conducted in the department of surgery, urology unit from March 2013 to February 2016. Total of 49 patients were enrolled and were randomly divided into Group A and Group B. In Group A, all the patients were taught ISD with Nelaton Catheter after FFUD. In group B, all patients underwent only FFUD for urethral stricture. In both groups, Foley's catheter was removed after 2 weeks of FFUD. These patients who had difficulty In passing urine or having lower urinary tract syndrome after removal of catheter, were evaluated for urethral stricture recurrency by clinical symptoms, ultrasonography, urine test for culture and sensitivity, cystoscopy/urethrogram as necessarily.Result: In Group A, 4 patients out of 20(20%)developed urethral stricture recurrency where as in Group B,18 patients out of 23 (78.26%) developed urethral stricture recurrency. Therefore, the rate of urethral stricture recurrence is significantly more in group B than the Group A (p< 0.001).Conclusion: ISD is an effective way for the prevention of urethtral stricture recurrence after FFUD. JNGMC,  Vol. 14 No. 2 December 2016, Page: 38-40

Lichen sclerosis–induced long segment anterior urethral stricture: The early outcome of one-stage repair using dorsolateral onlay buccal mucosa graft

2021 ◽  
pp. 039156032110033
Author(s):  
Atef Fathi ◽  
Omar Mohamed ◽  
Osama Mahmoud ◽  
Gamal A Alsagheer ◽  
Ahmed M Reyad ◽  
...  
Keyword(s):  
Success Rate ◽  
Urethral Stricture ◽  
Flow Rate ◽  
Urine Volume ◽  
Maximum Flow ◽  
Maximum Flow Rate ◽  
P Value ◽  
Onlay Graft ◽  
Voiding Symptoms ◽  
Stricture Recurrence

Background: Substitution urethroplasty using buccal mucosal grafts can be performed by several approaches including ventral onlay graft, dorsal onlay graft, or ventral urethrotomy with dorsal inlay graft. Our study aims to evaluate the surgical outcome of dorsolateral buccal mucosal graft for long segment anterior urethral stricture >6 cm in patients with Lichen sclerosus (LS). Methods: A retrospective study included patients who underwent repair for long segment anterior urethral stricture >6 cm due to LS between January 2013 and April 2019. All patients were followed-up at 3, 6, 9, and 12 months postoperatively and then yearly by clinical symptoms, uroflowmetry, and calculation of post-void residual urine volume. Retrograde urethrogram was requested for patients with voiding symptoms or decreased maximum flow rate. Stricture recurrence that required subsequent urethrotomy or urethroplasty was considered failure. The success rate and surgical complications were collected and analyzed. Results: Thirty patients were identified. The median age (range) was 39 (25–61) years and a median (range) stricture length was 8 (6–14) cm. Most of postoperative complications were of minor degree. The success rate at median follow-up of 15 (12–24) months was 86.5%. The median maximum flow rate increased significantly from 6 (2–11) ml/s preoperatively to 18 (range: 6–23) ml/s at the 6th month ( p value < 0.001). Conclusion: Dorsolateral buccal mucosal grafts urethroplasty for long anterior urethral stricture caused by LS has a high success rate and low risk of complications including stricture recurrence.

scholarly journals Efficacy of Use of Triamcinolone Ointment for Clean Intermittent Self Catheterization following Internal Urethrotomy.

2018 ◽  
Vol 56 (212) ◽  
pp. 745-748
Author(s):  
Sunil Regmi ◽  
Sunil Chandra Adhikari ◽  
Saroj Yadav ◽  
Rabin Raj Singh ◽  
Ravi Bastakoti
Keyword(s):  
Recurrence Rate ◽  
Patient Characteristics ◽  
Control Group ◽  
Internal Urethrotomy ◽  
Recurrence Rates ◽  
Urethral Strictures ◽  
Time To Recurrence ◽  
Water Based ◽  
Male Patients ◽  
Stricture Recurrence

Introduction: Internal urethrotomy is recommended for the treatment of urethral strictures shorter than 1.5 cm but has been associated with high recurrence rates. The aim of this study was to evaluate the efficacy of use of triamcinolone ointment for clean intermittent self catheterization in the prevention of urethral stricture recurrence after internal urethrotomy. Methods: Total of 60 male patients undergoing internal urethrotomy were assigned into two groups and clean intermittent self catheterization was performed using either triamcinolone ointment or a water-based gel for lubrication of the catheter in this randomized clinical trial. Clean intermittent self catheterization regimen was continued for 6 months and patients were followed for 12 months. Urethrocystoscopic evaluation was done 6 and 12 months postoperatively. Results: The recurrence rates were compared between the two groups. There were no significant differences in patient characteristics and etiology of the stricture between the two groups. There was a 6 (22.22%) recurrence rate in the patients of the triamcinolone group against 13 (46.42%) in those of the control group after the first internal urethrotomy (P=0.04). After second internal urethrotomy, the urethra was stabilized in 5 (83.3%) of the patients in the triamcinolone group and 8 (61.5%) those in the control group (P=0.05). We also found a significant correlation between recurrence and stricture length (P=0.02) but the time to recurrence was not statistically significant (P=0.16). Conclusions: The use of triamcinolone ointment in patients on CISC regimen after internal urethrotomy significantly decreased the stricture recurrence rate.

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 &lt; 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 &lt; 0.05). Conclusion: We believe that plasmakinetic surgery is better method than the cold knife technique for the treatment of urethral stricture.

scholarly journals MBCL-26. FACTORS ASSOCIATED WITH LONGER SURVIVAL AFTER FIRST RECURRENCE IN MEDULLOBLASTOMA BY MOLECULAR SUBGROUP AFTER RISK-BASED INITIAL THERAPY

2020 ◽  
Vol 22 (Supplement_3) ◽  
pp. iii394-iii394
Author(s):  
Murali Chintagumpala ◽  
Colton Terhune ◽  
Lin Tong ◽  
Eric Bouffet ◽  
Ute Bartels ◽  
...  
Keyword(s):  
Initial Therapy ◽  
Initial Diagnosis ◽  
Therapeutic Modality ◽  
P Value ◽  
Molecular Subgroup ◽  
Factors Associated ◽  
Time To Recurrence ◽  
Group 4 ◽  
Kaplan Meier ◽  
First Recurrence

Abstract OBJECTIVE To evaluate differences in time to recurrence among molecular subgroups of medulloblastoma treated on a single protocol and to identify factors associated with survival after first recurrence. METHODS Time to recurrence following SJMB03 treatment was compared across methylation subgroups among relapsed patients. Therapies received subsequent to relapse were noted. Kaplan-Meier methods and log-rank tests were used for statistical analyses. RESULTS 74 of 330 medulloblastoma patients developed recurrence after initial therapy. (38 Standard-Risk; 36 High-Risk). The 2- and 5-year survival after first recurrence was 30.4% and 14.6% respectively. DNA methylation-based subgroups from initial diagnosis were SHH (n=14), Group 3 (n=24), Group 4 (n=26), and unclassified (n=8). None of the pts with WNT MB had recurrent disease. Median time to first recurrence was 1.23, 0.91, and 3.09 years in SHH, Group3, and Group 4 respectively. Group 4 patients had longer post-recurrence survival than others (p-value=0.0169). Clinical risk at diagnosis (p-value=0.337), anaplasia (p-value=0.4032), TP53 (p-value=0.1969), MYC (p-value=0.8967), and MYCN (p value = 0.9404) abnormalities were not associated with post progression survival. Patients who received any therapeutic modality (chemotherapy, re-radiation and second surgery) had longer survival and those who had all three (n=10) had the best outcome (p-value&lt;0.0001). CONCLUSION Outcome after recurrence in medulloblastoma is dismal, however, association with subgroups is still present. Group 4 patients had a longer time to recurrence and post progression survival. No other prognostic factor at initial diagnosis was associated with outcome after recurrence. Patients who received all 3 types of conventional therapy had better survival.

scholarly journals Use of intra-urethral steroid clobetasol cream to prevent the recurrence of urethral stricture after optical urethrotomy: Randomized clinical trial

Mediscope ◽  
2019 ◽  
Vol 6 (2) ◽  
pp. 59-63
Author(s):  
M Ahmed ◽  
SM Hossain ◽  
MT Islam ◽  
G Kobir ◽  
BK Basu
Keyword(s):  
Urethral Stricture ◽  
Topical Steroid ◽  
Scar Tissue ◽  
Tissue Formation ◽  
Internal Urethrotomy ◽  
Proliferative Effect ◽  
Urethral Strictures ◽  
Stricture Recurrence ◽  
Optical Internal Urethrotomy ◽  
Scar Tissue Formation

Background: One of the most frequently used treatments of urethral strictures is the optical internal urethrotomy (OIU). About 20%-60% of urethral stricture patients develop recurrent stricture after Urethrotomy. Glucocorticoids have proved anti-proliferative effect and thereby used to reduce the formation of scar tissue. In urethral stricture, the main pathology is scar tissue formation. Objective: The aim of this study is to see the influence the local application of steroid clobetasol cream after Urethrotomy. Method: Between January to December 2016, all Bulbar urethral stricture patients attended to the hospital and private clinics, were included in this study. They were placed in two groups alternatively. They underwent standard OIU. First group (35 patients) offered clean intermittent self-catheterization (CISC) postoperatively without any steroid cream in urethra. The second group (35 patients) practiced CISC in the same way but used clobetasol cream with catheter. Both groups used topical anaesthesic Lidocain HCL for lubrication of urethra. Result: No patient developed recurrence with clobetasol cream after 3 months, but two patients developed recurrence without steroid. At 6 months, this result is 6 (17.14%) and 10 (28.57%) accordingly. Conclusion: Topical steroid clobetasol cream reduces urethral stricture recurrence. Mediscope Vol. 6, No. 2: Jul 2019, Page 59-63

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