scholarly journals Post-Surgical Outcomes of Dorsolateral Onlay Urethroplasty

2017 ◽  
Vol 7 (2) ◽  
pp. 16-19
Author(s):  
Chowdhury ATM Mowladad ◽  
Khan Mohiur Rahman ◽  
Ahmed Bakhtiar ◽  
Hassan Rafiqul ◽  
Rahman Shofiqur ◽  
...  
Keyword(s):  
Urethral Stricture ◽  
Maximum Flow ◽  
Vascular Supply ◽  
Successful Outcome ◽  
Urethral Reconstruction ◽  
Medical College ◽  
Urethral Strictures ◽  
Standard Management ◽  
Retrograde Urethrogram ◽  
Poor Outcomes

Background: The standard management of urethral strictures involving the anterior urethra is dorsal onlay buccal mucosa augmentation urethroplasty. This requires circumferential mobilisation of the urethra, which might cause ischemia of the urethra in addition to chordee. In this research, we managed the anterior urethral stricture, applying a dorsolateral onlay urethroplasty.Methodology: This prospective study was conducted in the Department of Urology, BIRDEM General Hospital& some private hospitals from July 2009 to June 2015, the outcomes of a total cases of 103 of one sided anterior dorsolateral onlay OMG Urethroplastywere assess and compared. Patients with anterior and recurrent urethral stricture more than 1 cm were included as study population. Urethrogram and Uroflowmetry were the mainstay of assessment. Success was defined as a maximum flow rate of>20 ml/sec., normal RGU, and/or urethroscopy. Poor outcomes were defined as the presence of obstructive urinary tract symptoms, Qmax <15 ml/sec., stricture diagnosed on retrograde urethrogram/ urethroscopy, and the need for any postoperative urethral intervention.Result: Of the 103 patients, 97 had (94.2%) successful outcome and 6 (5.8%) were failure. Four failed cases underwent optical internal urethrotomy and two patients had persistent narrowing and they were managed by BMG Urethroplasty. Follow up period was 12 months on an average. In conclusion, it can be said thatthe preservation of one sided vascular supply to the urethra and its entire muscular and neurogenic support represent significantly towards perfecting the surgical technique of urethral reconstruction using a minimally invasive approach.Conclusion: In this study, we found it to be a technically feasible, easily adoptable and finally successful procedure.Anwer Khan Modern Medical College Journal Vol. 7, No. 2: Jul 2016, P 16-19

scholarly journals Dorsal Onlay Buccal Mucosal Graft Urethroplasty for Bulbar Urethral Stricture- Experience of 20 Cases

2017 ◽  
Vol 26 (1) ◽  
pp. 8-11
Author(s):  
Hafiz Al Asad ◽  
AKM Musa Bhuiyan ◽  
Md Nazmul Islam ◽  
Uttam Karmaker ◽  
Md Shafiqul Alam Chowdhury ◽  
...  
Keyword(s):  
Successful Outcome ◽  
Anastomotic Site ◽  
Medical College ◽  
Urethral Strictures ◽  
Buccal Mucosal Graft ◽  
Onlay Technique ◽  
Retrograde Urethrogram ◽  
Dorsal Onlay ◽  
Optical Internal Urethrotomy

Objective: To assess the success of buccal mucosal graft (BMG) urethroplasty by the dorsal onlay technique in bulbar urethral stricture.Materials and Methods: From July 2008 to June 2010, twenty patients with anterior urethral strictures were managed by dorsal onlay BMG urethroplasty. After voiding trial, they were followed up at 3 weeks and 3 months with history, physical examination, uroflowmetry and retrograde urethrogram (RGU) if required. Patients were further followed-up at 3 months interval with uroflowmetry and retrograde urethrogram (RGU) if required. Successful outcome was defined as normal voiding with no surgical intervention after catheter removal.Results: Mean stricture length was 3.5 ± 0.8 cm and mean follow up was 12 months (range 6 to 24 months). Two patients were found to develop stricture at anastomotic site, during followup and required optical internal urethrotomy and was considered as failure. One patient developed wound infection which resolved after regular dressing. Success rate was 90%.Conclusion: Dorsal onlay BMG urethroplasty is a simple technique with good surgical outcome.J Dhaka Medical College, Vol. 26, No.1, April, 2017, Page 8-11

Outcome of Dorsolateral OnlAy OMG Urethroplasty for Anterior Urethral Stricture

2020 ◽  
Vol 16 (2) ◽  
pp. 37-42
Author(s):  
Tohid Md Saiful Hossain ◽  
Md Asaduzzaman ◽  
Md Afzalur Rahman ◽  
Md Nasir uddin ◽  
Md Habibur Rahman ◽  
...  
Keyword(s):  
Oral Mucosa ◽  
Urethral Stricture ◽  
Donor Site ◽  
Maximum Flow ◽  
Successful Outcome ◽  
Term Outcome ◽  
Lower Lip ◽  
Urethral Strictures ◽  
Buccal Mucosal Graft

Objective: To determine the feasibility, safety, efficacy and short term outcome of using new surgical technique for repair of anterior urethral stricture Introduction: The conventional approach for management of long segment anterior urethral stricture is a two stage Johansons repair along with the use of free grafts if required. Now a days the preferred management of urethral stricture involving long segments of anterior urethra is dorsal only oral mucosa Augmentation urethroplasty which requires circumferential mobilization of urthera that might cause ischaemia of urethra in addition of chordee. For that we adopted new technique (kulkarnis) of dorsolateral onlay buccal mucosal graft one sided anterior urethroplasty in which only unilateral urethral mobilization done through perineal approach. Materials and Methods: A total of 50 patients underwent urethroplasty for anterior urethral strictures using dorsolateral onlay BMG from April 2010 to December 2012 at NIKDU, JBFH, BSMMU and BDM Hospital. We selected 16 to 70 years old male (mean age 39 years) underwent a one-sided dorsolateral oral mucosal graft urethroplasty. The mean (range) stricture length was 6.5 (4.5-9) cm in patients with single bulbar urethral involvement and 10.5 (8.5–15.0) cm in patients with panurethral strictures. Free graft was taken from oral mucosa either lower lip or cheeks. Follow up was done by uroflowmetry at 3rd week, after removal of penile catheter and repeat at 3rd and at 6th month. In addition to uroflometry – RGU & MCU was done at 3rd month and Urethrocystoscopy was done at 6th month follow up. The results were classified into the following outcomes. Success was defined as a maximum flow rate of >10 ml/sec, normal RGU, and/or urethroscopy (with a 19 Fr. sheath). Failure was defined as the presence of obstructive urinary tract symptoms, Qmax <10 ml/sec, stricture diagnosed on retrograde urethrogram/ urethroscopy, and the need for any postoperative urethral intervention. Result: The overall follow up was 12-30 months. Of the 50 patients 45 (90%) had a successful outcome and 5(12%) had failure. 3 failure treated by OIU and 2 by meatal dilatation. No significant donor site defect was observed. Bangladesh Journal of Urology, Vol. 16, No. 2, July 2013 p.37-42

scholarly journals Outcome of Dorsal Onlay Urethroplasty for Long Segment Anterior Urethral Stricture: Experience of 31 Cases

2020 ◽  
Vol 19 (1) ◽  
pp. 28-31
Author(s):  
Hafiz Al Asad ◽  
Prodyut Kumar Saha ◽  
AKM Shahadat Hossain ◽  
Md Waliul Islam ◽  
Akm Musa Bhuiyan
Keyword(s):  
Urethral Stricture ◽  
Kidney Diseases ◽  
Successful Outcome ◽  
Anastomotic Site ◽  
Short Term ◽  
Term Outcome ◽  
Buccal Mucosa Graft ◽  
Retrograde Urethrogram ◽  
A Prospective Study

Objective: To determine the short-term outcome of dorsolateral onlay urethroplasty in the treatment of long segment anterior urethral stricture. Materials and Methods: A prospective study from May 2011 to September 2012 is carried out in department of Urology, National Institute of Kidney Diseases and Urology, Sher-EBanglanagar, Dhaka. Thirty one patients with long anterior urethral stricture were treated by a dorsolateral onlay buccal mucosa graft. After voiding trial, they were followed up at 3 weeks and 3 months with history, physical examination, uroflowmetry and retrograde urethrogram (RGU) if required (uroflowmetry <15 ml/sec). Patients were further followedup at 3 months interval with uroflowmetry and retrograde urethrogram (RGU) if required (uroflowmetry <15 ml/sec). Successful outcome was defined as normal voiding with no surgical intervention after catheter removal. Results: Mean stricture length was 42.49±12.77 mm (range 24-70 mm) and mean follow up was 8 months (range 6 to 12 months). Three patients were found to develop stricture at anastomotic site, during follow-up and required optical internal urethrotomy and was considered as failure. One patient developed wound infection which resolved after regular dressing. Success rate was 90.32%. Conclusion: Dorsolateral onlay BMG urethroplasty is feasible for long anterior urethral stricture with good short term surgical outcome. Bangladesh Journal of Urology, Vol. 19, No. 1, Jan 2016 p.28-31

scholarly journals Dorsolateral Onlay Urethroplasty for the Long Segment Anterior Urethral Stricture: Outcome of 31 Cases

2020 ◽  
Vol 18 (1) ◽  
pp. 12-15
Author(s):  
Hafiz Al Asad ◽  
Md Sharif Shahjamal ◽  
Sarforaj Ali Khan ◽  
Md Waliul Islam ◽  
AKM Zamanul Islam Bhuiyan
Keyword(s):  
Urethral Stricture ◽  
Kidney Diseases ◽  
Successful Outcome ◽  
Anastomotic Site ◽  
Short Term ◽  
Buccal Mucosa Graft ◽  
Retrograde Urethrogram ◽  
A Prospective Study ◽  
Optical Internal Urethrotomy

Objective: This study is designed to observe the short-term outcomes of dorsolateral onlay urethroplasty to treat long segment anterior urethral stricture. Materials and Methods: A prospective study from May 2011 to September 2012 is carried out in department of Urology, National Institute of Kidney Diseases and Urology, Sher-EBanglanagar, Dhaka. Thirty one patients with long anterior urethral stricture were treated by a dorsolateral onlay buccal mucosa graft. After voiding trial, they were followed up at 3 weeks and 3 months with history, physical examination, uroflowmetry and retrograde urethrogram (RGU) if required (uroflowmetry <15 ml/sec). Patients were further followedup at 3 months interval with uroflowmetry and retrograde urethrogram (RGU) if required (uroflowmetry <15 ml/sec). Successful outcome was defined as normal voiding with no surgical intervention after catheter removal. Results: Mean stricture length was 42.49±12.77 mm (range 24-70 mm) and mean follow up was 8 months (range 6 to 12 months). Three patients were found to develop stricture at anastomotic site, during follow-up and required optical internal urethrotomy and was considered as failure. One patient developed wound infection which resolved after regular dressing. Success rate was 90.32%. Conclusion: Dorsolateral onlay BMG urethroplasty is feasible for long anterior urethral stricture with good short term surgical outcome. Bangladesh Journal of Urology, Vol. 18, No. 1, Jan 2015 p.12-15

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 Dorsal Onlay Oral Mucosa Graft Urethroplasty: A Case Report and Review of Literature

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Kwaku Addai Arhin Appiah ◽  
Christian Kofi Gyasi-Sarpong ◽  
Edwin M. T. Yenli ◽  
Patrick Opoku Manu Maison ◽  
Charles Kwame Adofo ◽  
...  
Keyword(s):  
Case Report ◽  
Oral Mucosa ◽  
Urethral Stricture ◽  
Buccal Mucosa ◽  
Urethral Reconstruction ◽  
Review Of Literature ◽  
Urethral Strictures ◽  
Dorsal Onlay ◽  
Successful Repair ◽  
Oral Mucosa Graft

The use of buccal mucosa grafts in urethral reconstruction for complex anterior urethral strictures has gained popularity over the years with very good outcomes reported in literature. We report on the successful repair of a complex anterior urethral stricture in a 14-year-old boy following catheterization using this method at the Komfo Anokye Teaching Hospital. The aim is to describe the method of dorsal onlay oral mucosa graft urethroplasty and to review the literature.

scholarly journals Comparing retrograde urethrography readings with intraoperative findings in urethral stricture

2019 ◽  
Vol 7 (6) ◽  
pp. 2333
Author(s):  
Tanvi Subhash Kelkar ◽  
Anil Joshi
Keyword(s):  
Urinary Tract ◽  
Urethral Stricture ◽  
Lower Urinary Tract ◽  
Operating Characteristics ◽  
Medical College ◽  
Urethral Strictures ◽  
Retrograde Urethrography ◽  
Common Location ◽  
Operative Findings ◽  
Lower Urinary

Background: Urethral strictures are relatively common in men with most patients acquiring the disease due to injury or infection. The present study was conducted to assess the accuracy of retrograde urethrography (RGU) in diagnosing urethral strictures in patients presenting with lower urinary tract symptoms.Methods: All male patients presenting with lower urinary tract symptoms and referred for retrograde urethrogram to the Department of Radiodiagnosis, Bharati Vidyapeeth Medical College and Hospital (Deemed to be University), Sangli from November 2018 till January 2019 were included. The parameters of RGU were compared with intra-operative findings as gold standard to calculate the operating characteristics of RGU.Results: The present study included 42 patients, mean age 54.9±11.2 years. Grade I urethral stricture was observed in 42.8% and 26% had grade II stricture. Bulbar stricture was the most common location. The common presenting complaints were increased frequency (50%) and dribbling micturition (40.4%). Approximately one tenth of all patients had a history of trauma. RGU was 100% sensitive and 66.7% specific in detecting strictures of less than 2 cm. Overall accuracy of RGU in detecting urethral strictures of less than 2 cm was 83.3%.Conclusions: RGU is a reliable means for establishing the diagnosis of a suspected urethral stricture and also provides accurate staging information with regard to stricture number, length, location, and coexistent urethral pathology.

scholarly journals Tubularized Urethral Reconstruction Using Everted Saphenous Vein Graft in A Beagle Model

2020 ◽  
Author(s):  
Dan Li ◽  
Zhou Shen ◽  
Yujie Xu
Keyword(s):  
Urethral Stricture ◽  
Saphenous Vein ◽  
Vein Graft ◽  
Saphenous Vein Graft ◽  
Control Group ◽  
Urethral Reconstruction ◽  
Urethral Strictures ◽  
Retrograde Urethrography ◽  
Urethral Defect ◽  
Experimental Group

Abstract Background: The repair of anterior urethral stricture and hypospadias require urethral reconstruction. We conduct the study to investigate the efficacy of anterior urethral reconstruction using everted saphenous vein graft in tubular fashion. Methods: Twelve male beagles were randomly divided into three groups: experimental group( n=5), control group( n=5) and normal group( n=2). A 3 cm defect in anterior urethra was created. Autologous saphenous vein graft was harvested. In experimental group, urethral defect was replaced by everted saphenous vein graft in tubular fashion. In control group, urethral reconstruction was performed using uneverted saphenous vein graft. At 6 months postoperatively, beagles in all groups received retrograde urethrography to evaluate urethral patency and were killed for histological examination. Results: Retrograde urethrography showed the urethral caliber of beagles in experimental group were similar to those of normal. Ether urethral stricture or fistula were detected in all animals in control group. In experimental group, the everted saphenous vein graft completely integrated into the urethra. The reconstructed urethra had a wide lumen and was completely covered by urothelium. The subepithelial collagen and muscle fibers were well formed and highly organized. Everted saphenous vein graft had a high ability of neovascularization. In control group, the reconstructed segment had a fibrotic urethral lumen in which urothelium was not intact. And there were few newly formed capillaries. Conclusions: Everted saphenous vein graft can be used as tubular substitute material for anterior urethral strictures and hypospadias.

scholarly journals Dorsal Onlay Buccal Mucosal Graft Urethroplasty for Bulbar Urethral Stricture- Experience Of 20 Cases

2015 ◽  
Vol 23 (2) ◽  
pp. 175-178
Author(s):  
Hafiz Al Asad ◽  
AKM Musa Bhuiyan ◽  
Md Nazmul Islam ◽  
Uttam Karmaker ◽  
Md Shafiqul Alam Chowdhury ◽  
...  
Keyword(s):  
Simple Technique ◽  
Anastomotic Site ◽  
Medical College ◽  
Urethral Strictures ◽  
Buccal Mucosal Graft ◽  
Onlay Technique ◽  
Retrograde Urethrogram ◽  
Dorsal Onlay ◽  
Optical Internal Urethrotomy

Objective: To assess the success of buccal mucosal graft (BMG) urethroplasty by the dorsal onlay technique in bulbar urethral stricture.Materials and Methods: FromJuly 2008 to June 2010, twenty patients with anterior urethral strictures weremanaged by dorsal onlay BMG urethroplasty. After voiding trial, they were followed up at 3 weeksand 3 months with history, physical examination, uroflowmetryand retrograde urethrogram (RGU) if required. Patients were furtherfollowed-up at 3 months interval with uroflowmetry and retrograde urethrogram (RGU) if required. Successfuloutcome was defined as normal voiding with no surgical intervention after catheter removal.Results: Mean stricture length was 3.5 ± 0.8 cm and mean follow up was 12 months (range 6 to 24 months). Twopatients were found to develop stricture at anastomotic site, during followup and required optical internal urethrotomy and was considered as failure.One patient developed wound infection which resolved after regular dressing. Success rate was 90%.Conclusion: Dorsal onlay BMG urethroplasty is a simple technique with good surgical outcome.J Dhaka Medical College, Vol. 23, No.2, October, 2014, Page 175-178

scholarly journals A False Route Case of Primary Excision Anastomosis (EPA) Procedure in The Treatment of Traumatic Bulbar Urethral Stricture

2019 ◽  
Vol 2 (3) ◽  
Author(s):  
I Gusti Ayu Putri Purwanthi ◽  
Gede Wirya Kusuma Duarsa ◽  
Tjok Gde Agung Senapathi
Keyword(s):  
Urethral Stricture ◽  
Primary Anastomosis ◽  
Psychological Problem ◽  
Pelvic Injury ◽  
Urethral Reconstruction ◽  
Unexpected Result ◽  
Urethral Strictures ◽  
Radiologic Evaluation ◽  
History Of

The bulbar urethra stricture is the most common form of anterior urethral stricture. The treatment of urethral strictures are varies and remains a challenging field in urology. Excision Primary Anastomosis (EPA) described as the most effective intervention for traumatic urethral stricture cases with a long-term success rate. This case report described male, 42 years old with history of pelvic injury. He had underwent cystostomy and conservative management for his pelvic injury. After EPA and pubectomy procedure in September 2019, he was still unable to void from his urethra. Radiologic evaluation with BVUC was done on October 2019, showing total obstruction of urethral as high as superior aspects of pars bulbosa, unfavourable anastomosed and displaced urethra. Acquired urethral stricture or fistula is an unexpected result of urethral reconstruction and leads to much inconvenience as well as psychological problem for the patient. This condition is avoidable by operation that was performed by experienced urologist and using a flexible cystoscopy as a guidance.

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