Treatment of urethral strictures with balloon dilation: A forgotten tale

Urethral stricture is a common condition that can lead to serious complications such as urinary infections and renal insufficiency secondary to urinary retention. Treatment options include catheterization and dilation, urethroplasty and endoscopic internal urethrotomy as well. Although treatment option depends on the type, length and aetiology of stricture, the choice can be influenced to varying degrees by the simplicity of the method, the preferences of the patient the available accoutrements and the patient health condition. Both urethroplasty and endoscopic internal urethrotomy require anaesthesia and thus are not suitable for many elder and unfit for surgical treatment patients. On the other hand, dilations are easy to perform in every day clinical practice however they have been associated with iatrogenic urethral trauma. In contrast, balloon dilation under vision dilates by radial application of forces against the stricture, avoiding the potentially shearing forces associated with sequential rigid dilation. Since it reduces the possibility of an iatrogenic urethral trauma and the subsequent spongiofibrosis may lead into improved therapeutic outcomes. In this report we describe a technique for the treatment of urethral strictures with balloon dilation in elder and unfit for surgical treatment patients.

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A Simple Technique to Facilitate Treatment of Urethral Strictures with Optical Internal Urethrotomy

Case Reports in Urology ◽

10.1155/2014/137605 ◽

2014 ◽

Vol 2014 ◽

pp. 1-3 ◽

Cited By ~ 1

Author(s):

Konstantinos Stamatiou ◽

Aggeliki Papadatou ◽

Hippocrates Moschouris ◽

Ioannis Kornezos ◽

Anargiros Pavlis ◽

...

Keyword(s):

Simple Technique ◽

Treatment Options ◽

Internal Urethrotomy ◽

Urethral Catheterization ◽

Percutaneous Approach ◽

Urethral Strictures ◽

Minimal Scarring ◽

Urinary Infections ◽

Procedural Time ◽

Optical Internal Urethrotomy

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Internal urethrotomy versus plasmakinetic energy for surgical treatment of urethral stricture

Archivio Italiano di Urologia e Andrologia ◽

10.4081/aiua.2015.2.161 ◽

2015 ◽

Vol 87 (2) ◽

pp. 161 ◽

Cited By ~ 1

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.

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Recent Advances in treatment of urethral stricture disease in men

F1000Research ◽

10.12688/f1000research.21957.1 ◽

2020 ◽

Vol 9 ◽

pp. 330

Author(s):

Naside Mangir ◽

Christopher Chapple

Keyword(s):

Tissue Engineering ◽

Regenerative Medicine ◽

Urethral Stricture ◽

Treatment Options ◽

Internal Urethrotomy ◽

Engineering Research ◽

Urethral Stricture Disease ◽

Urethral Strictures ◽

Main Challenge ◽

Tissue Engineering Research

Urethral stricturing is a narrowing of the urethral lumen as a result of ischaemic spongiofibrosis. The main challenge of currently available treatment options is recurrence of the stricture. Recent advancements in the treatment of urethral strictures mainly came from the fields of regenerative medicine and tissue engineering. Research efforts have primarily focused on decreasing the recurrence of stricture after internal urethrotomy and constructing tissue-engineered urethral substitutes to improve clinical outcomes of urethroplasty surgeries. The aim of this article is to review the most recent advancements in the management of urethral stricture disease in men.

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Surgical treatment of urethral stricture disease – the earlier, the better

Folia Medica ◽

10.3897/folmed.63.e57517 ◽

2021 ◽

Vol 63 (4) ◽

pp. 481-487

Author(s):

Valeri Mariyanovski ◽

Emil Dorosiev ◽

Boris Mladenov

Keyword(s):

Surgical Treatment ◽

Sexual Function ◽

Reconstructive Surgery ◽

Open Surgery ◽

Treatment Options ◽

Functional Results ◽

Surgical Reconstruction ◽

Urethral Reconstruction ◽

Complication Rates ◽

Urethral Strictures

Introduction: Surgical treatment of urethral strictures is a constantly evolving process. There are various treatment options like internal urethrotomy (IUT) and open surgery. A variety of techniques for urethral reconstruction are available (grafts, flaps, and excision-reanastomosis). Functional results of urethral reconstructive surgery are very satisfying and with low rate of complications. Aim: We assessed the early open surgical reconstruction in comparison with the continuation with the endourological treatment – IUTs. Materials and methods: The study included 129 patients with urethral strictures referred to our center. At that time point, they had received two unsuccessful IUTs and were divided into two groups – consecutive IUT and surgical repair, which included excision and reanastomosis or augmented urethroplasty. These patients were evaluated at 12 months using urethrography and uroflowmetry. Sexual function was evaluated using the international index of erectile function questionnaire 5-IIEF. Chi-squared test for statistical analysis was used. Results: Successful outcomes (urethrography presented equal caliber and Qmax was >15 ml/sec 12 months after the procedure) were achieved in 59 (88%) of the patients using reconstructive surgery versus 26 (41.9%) of the patients with consecutive IUT (p<0.001). Mild sexual dysfunction was reported by 12 (17.9%) patients from the group with open surgery and 7 (11.3%) from the group with continuous IUT (p=0.289). Conclusions: Early open surgery seems a reasonable solution to the problem of urethral strictures as there are only a few complications from this surgery and the functional results are satisfactory. The success rate using open surgery was found to be significantly greater than that in the consecutive IUT group, whereas no differences in the complication rates regarding sexual function were observed.

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Surgical Treatment Options for Benign Glottic Lesions Inducing Vocal Insuffiency

Nihon Kikan Shokudoka Gakkai Kaiho ◽

10.2468/jbes.61.178 ◽

2010 ◽

Vol 61 (2) ◽

pp. 178-178

Author(s):

K. Saito

Keyword(s):

Surgical Treatment ◽

Treatment Options

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“Proximalization is Advancement”—Zone 3 Frozen Elephant Trunk vs Zone 2 Frozen Elephant Trunk: A Literature Review

Vascular and Endovascular Surgery ◽

10.1177/15385744211002493 ◽

2021 ◽

pp. 153857442110024

Author(s):

Rozina Yasmin Choudhury ◽

Kamran Basharat ◽

Syeda Anum Zahra ◽

Tien Tran ◽

Lara Rimmer ◽

...

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Surgical Treatment ◽

Literature Review ◽

Treatment Options ◽

Frozen Elephant Trunk ◽

Elephant Trunk ◽

Descending Aorta ◽

Cord Injury ◽

Aortic Pathologies

Over the decades, the Frozen Elephant Trunk (FET) technique has gained immense popularity allowing simplified treatment of complex aortic pathologies. FET is frequently used to treat aortic conditions involving the distal aortic arch and the proximal descending aorta in a single stage. Surgical preference has recently changed from FET procedures being performed at Zone 3 to Zone 2. There are several advantages of Zone 2 FET over Zone 3 FET including reduction in spinal cord injury, visceral ischemia, neurological and cardiovascular sequelae. In addition, Zone 2 FET is a technically less complicated procedure. Literature on the comparison between Zone 3 and Zone 2 FET is scarce and primarily observational and anecdotal. Therefore, further research is warranted in this paradigm to substantiate current surgical treatment options for complex aortic pathologies. In this review, we explore literature surrounding FET and the reasons for the shift in surgical preference from Zone 3 to Zone 2.

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The Investigation and Management of Adenomyosis in Women Who Wish to Improve or Preserve Fertility

BioMed Research International ◽

10.1155/2018/6832685 ◽

2018 ◽

Vol 2018 ◽

pp. 1-12 ◽

Cited By ~ 3

Author(s):

Jin-Jiao Li ◽

Jacqueline P. W. Chung ◽

Sha Wang ◽

Tin-Chiu Li ◽

Hua Duan

Keyword(s):

Surgical Treatment ◽

Minimally Invasive ◽

Treatment Options ◽

Management Strategies ◽

Definitive Treatment ◽

Surgical Approaches ◽

Child Bearing ◽

Fertility Sparing

The management of adenomyosis remains a great challenge to practicing gynaecologists. Until recently, hysterectomy has been the only definitive treatment in women who have completed child bearing. A number of nonsurgical and minimally invasive, fertility-sparing surgical treatment options have recently been developed. This review focuses on three aspects of management, namely, (1) newly introduced nonsurgical treatments; (2) management strategies of reproductive failures associated with adenomyosis; and (3) surgical approaches to the management of cystic adenomyoma.

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Internet of things-based cloud computing platform for analyzing the physical health condition

Technology and Health Care ◽

10.3233/thc-213003 ◽

2021 ◽

pp. 1-15

Author(s):

Mengyao Cui ◽

Seung-Soo Baek ◽

Rubén González Crespo ◽

R. Premalatha

Keyword(s):

Cloud Computing ◽

Internet Of Things ◽

Health Monitoring ◽

Tracking System ◽

Disease Diagnosis ◽

Health Condition ◽

Computing Platform ◽

Concept Model ◽

Patient Health ◽

Cloud Servers

BACKGROUND: Health monitoring is important for early disease diagnosis and will reduce the discomfort and treatment expenses, which is very relevant in terms of prevention. The early diagnosis and treatment of multiple conditions will improve solutions to the patient’s healthcare radically. A concept model for the real-time patient tracking system is the primary goal of the method. The Internet of things (IoT) has made health systems accessible for programs based on the value of patient health. OBJECTIVE: In this paper, the IoT-based cloud computing for patient health monitoring framework (IoT-CCPHM), has been proposed for effective monitoring of the patients. METHOD: The emerging connected sensors and IoT devices monitor and test the cardiac speed, oxygen saturation percentage, body temperature, and patient’s eye movement. The collected data are used in the cloud database to evaluate the patient’s health, and the effects of all measures are stored. The IoT-CCPHM maintains that the medical record is processed in the cloud servers. RESULTS: The experimental results show that patient health monitoring is a reliable way to improve health effectively.

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