scholarly journals Optical Internal Urethrotomy for Urethral Stricture Under a New Local Anaesthesia Technique

2020 ◽  
Vol 17 (2) ◽  
pp. 64-66
Author(s):  
Md Fazal Naser ◽  
Md Abul Hossain ◽  
Shafiqul Azam ◽  
Ahmed Saiful Jabbar ◽  
Md Shohrab Hossain

Objectives: To determine the feasibility of routinely performing internal optical urethrotomy for anterior urethral stricture under intracorpus spongiosum anesthesia in an outpatient setting. Methods. In this prospective study a consecutive series of 34 patients with anterior urethral stricture, a dosage of 3 mL of 1% lidocaine was slowly injected into the glans penis. Next, optical urethrotomy was performed immediately with a cold-cutting knife. The effect of this anesthetic technique was evaluated by questionnaire. Results. Internal urethrotomy was successfully completed in all the patients. Thirty-two patients (94.12%) had no pain or discomfort. Two patient reported minimal but tolerable discomfort while the tissue above the stricture was being cut. The anesthesia lasted for about 1.5 hours and was very satisfactory without any complications. Conclusions. Under intracorpus spongiosum anesthesia, optical urethrotomy can be routinely performed in an outpatient setting. With this new local anesthesia, internal urethrotomy is a safe, effective, simple, and inexpensive procedure for treatment of anterior urethral stricture. Bangladesh Journal of Urology, Vol. 17, No. 2, July 2014 p.64-66

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Wael Ali Maged ◽  
Mohamed Ahmed Gamal ◽  
Samuel Fayek Tawfeles

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.


2017 ◽  
Vol 11 (2) ◽  
pp. O34-O37 ◽  
Author(s):  
Yohei Kumano ◽  
Takashi Kawahara ◽  
Taku Mochizuki ◽  
Daiji Takamoto ◽  
Teppei Takeshima ◽  
...  

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Santosh Kumar ◽  
Nitin Garg ◽  
Shrawan Kumar Singh ◽  
Arup Kumar Mandal

Purpose. To study the efficacy of optical internal urethrotomy with intralesional injection of Vatsala-Santosh PGI tri-inject (triamcinolone, mitomycin C, and hyaluronidase) in the treatment of anterior urethral stricture.Material and Methods. A total of 103 patients with symptomatic anterior urethral stricture were evaluated on the basis of clinical history, physical examination, uroflowmetry, and retrograde urethrogram preoperatively. All patients were treated with optical internal urethrotomy followed by injection of tri-inject at the urethrotomy site. Tri-inject was prepared by diluting the combination of triamcinolone 40 mg, mitomycin C 2 mg, and hyaluronidase 3000 in 5–10 mL of saline according to length of stricture. An indwelling 18 Fr silicone catheter was left in place for a period of 7–21 days. All patients were followed up for 6–18 months postoperatively on the basis of history, uroflowmetry, and, if required, retrograde urethrogram and micturating urethrogram every 3 months.Results. The overall recurrence rate after first OIU is 19.4% (20 out of 103 patients), that is, a success rate of 80.6%. Overall recurrence rate after second procedure was 5.8% (6 out of 103 patients), that is, a success rate of 94.2%.Conclusion. Optical internal urethrotomy with intralesional injection of Vatsala-Santosh PGI tri-inject (triamcinolone, mitomycin C, and hyaluronidase) is a safe and effective minimally invasive therapeutic modality for short segment anterior urethral strictures.


2019 ◽  
Vol 48 (1) ◽  
pp. 31-38
Author(s):  
Mohammad Humayun Kabir Bhuiyun ◽  
Abu Masud Al Mamun ◽  
Towhid Belal ◽  
Rezawanul Haque Rabbani ◽  
Md Khairul Islam ◽  
...  

Optical urethrotomy has been considered standard therapy for anterior urethral stricture since its introduction in 1976. Now optical internal urethrotomy (OIU) with intralesional triamcinolone injection is a safe and effective, minimally invasive therapeutic modality. The aim of the study is to compare the outcome of OIU alone and OIU with intralesional triamcinolone injection in the treatment of anterior urethral stricture. This Quasi Experimental study was carried out among 50 male patients with bulbar urethral stricture in the Department of Urology, Dhaka Medical College Hospital, Dhaka, over a period of six months. The age range of the patients were 32-46 years and patients were divided equally into two groups, OIU with and without intralesional triamcinolone acetonide injection as Group- A (experimental group, 25 patients) and Group- B (control group, 25 patients). Post-operative evaluation was done on the basis of history and uroflowmetry. Retrograde urethrography and micturating cystourethrography were done only in patient who developed obstructive voiding problems or flow rate below 10 ml/second. Follow up was done at regular interval on 7th day, 3rd month and 6th month. Post-operative outcomes were compared between two groups. Post-operative infection was significantly higher among those OIU with intralesional Triamcinolone acetonide injection (8%) than patients without intralesional Triamcinolone acetonide injection (4%). Per operative extravasations of urine were significantly higher among those without intralesional Triamcinolone acetonide injection (4%) than subjects with intralesional Triamcinolone acetonide injection. Extravasation not influenced by steroid but this patient subsequently suffered recurrence of stricture. In Group-A, pre and post-operative Q-max were 10.25±2.21 and 22.11±2.96 ml/sec respectively. In Group-B, pre and post-operative follow up Q-max were 10.37±2.55 and 19.54±2.65 mi/sec respectively. In Group-A, pre and post-operative voiding time was 85.20±4.20 and 27.10±3.36 sec respectively. In Group-B, pre and post-operative follow up voiding time were 86.37±4.55 and 31.45±2.55 sec respectively. Post-operative recurrences of stricture were significantly higher among those without intralesional Triamcinolone acetonide injection (24%) than subjects with intralesional Triamcinolone acetonide injection (12%). Post-operative it seems that triamcinolone injection after OIU is safe method to prevent the recurrence of urethral stricture Bangladesh Med J. 2019 Jan; 48 (1): 31-38


2020 ◽  
Vol 22 (2) ◽  
pp. 128-131
Author(s):  
Mohammad Abdul Aziz ◽  
Shafiqur Rahman ◽  
Mirza Mahbubul Hasan

Objective: To share our experience with buccal mucosal graft (BMG) urethroplasty for the management of anterior urethral strictures in BIRDEM General Hospital, Dhaka. Materials and methods: This study was conducted from January 2013 to January 2018. Patients selected according to inclusion and exclusion criteria. The oral mucosal characteristics were assessed in all patients during the initial workup. Single stage dorsolateral onlay graft urethroplasty done in all patients. They were followed according schedule for outcome and complications. Result:Total 59 patients were studied. Overall success rate of BMG urethroplasty was 88.1% at 12th month. Complications include development of periurethral abscess (3.4%), restructure (8.5%) development of fistula (1.7%). Total 8 patients underwent retreatment procedures like drainage of periurethral abscess, dilatation, optical internal urethrotomy (OIU) and revision urethroplasty. Conclusion:The buccal mucosa is easy to obtain and handle, therefore BMG urethroplasty is a safe and effective in managing anterior urethral stricture. Bangladesh Journal of Urology, Vol. 22, No. 2, July 2019 p.128-131


Mediscope ◽  
2019 ◽  
Vol 6 (2) ◽  
pp. 59-63
Author(s):  
M Ahmed ◽  
SM Hossain ◽  
MT Islam ◽  
G Kobir ◽  
BK Basu

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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