scholarly journals The effect of recurrent direct vision internal urethrotomy for short anterior urethral strictures on the disease course and the predictors of treatment failure

2018 ◽  
Vol 13 (9) ◽  
Author(s):  
Hüseyi̇n Aydemi̇r ◽  
Hasan Salih Sağlam ◽  
Osman Köse ◽  
Anıl Erdik ◽  
Fikret Halis ◽  
...  
Keyword(s):  
Urethral Stricture ◽  
Treatment Method ◽  
Direct Vision ◽  
Disease Course ◽  
Internal Urethrotomy ◽  
Comorbidity Score ◽  
Urethral Strictures ◽  
Number Of Patients ◽  
The Mean ◽  
Negative Predictive Factor

Introduction: The objective of this study was to investigate the disease course after direct vision internal urethrotomy (DVIU) for short anterior urethral strictures. Methods: We retrospectively analyzed 94 patients who underwent DVIU of the anterior urethra. Patients' age, etiology, length and localization of the strictures, total number of DVIU procedures, comorbidities, and other data were evaluated. Results: The mean age of the patients was 67.2 years. The mean followup duration was 27.1 months. Recurrence was observed in 27.6% of the patients. Recurrence had occurred in these patients at a mean of 12 months. Both the comorbidity score (rs=0.395; p<0.001) and the urinary tract infection (UTI) score (rs=0.492; p<0.001) had significant correlation with the recurrence. In patients with recurrent urethral stricture, as the number of DVIU increased, the length and number of the urethral stricture increased as well. Patients with recurrence had a single stricture in the first DVIU procedure, while the number of strictures increased to a mean of two in the second and/or third DVIU procedures. Conclusions: DVIU is an effective treatment method in short anterior urethral stricture if it has been applied as a first intervention. However, if the stricture recurs, repeated DVIU application appears to be a negative predictive factor. The presence of perioperative treated UTI, smoking, and total number of comorbidities were negative predictive factors for the recurrence of urethral stricture. The disadvantages of our study is that it is retrospective, it includes a low number of patients, and the followup period is short.

scholarly journals The Effects of Hyaluronic Acid in Preventing Recurrence of Urethral Stricture after Visual Internal Urethrotomy

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
H H G Hasan ◽  
M K A Tolba ◽  
M M M Shalaby
Keyword(s):  
Hyaluronic Acid ◽  
Recurrence Rate ◽  
Urethral Stricture ◽  
Large Scale ◽  
Control Group ◽  
Urethral Reconstruction ◽  
Internal Urethrotomy ◽  
Randomized Controlled ◽  
Voiding Symptoms ◽  
Number Of Patients

Abstract Background Many urologists prefer Visual internal urethrotomy (VIU)because of its ease to perform, short hospital stay, low cost, and perceived low complication rate. They may repeat VIU several times to avoid complex urethral reconstruction, because it requires significant surgical experience. Because of its effectiveness and simplicity, VIU is the primary treatment option for urethral stricture disease. However, the recurrence rate is high and the success rate is low. Aim of the Work To evaluate the effect of hyaluronic acid (HA) instillation during visual internal urethrotomy (VIU) for decreasing the incidence of recurrent urethral stricture. Patients and Methods A total of 50 patients who were treated by Visualized internal uretherotomy for urethral stricture between February 2017 and January 2019 were invited to participate in the present study. This study is a multicenter,prospective, randomized controlled, single-blinded study. Results In this study the experimental group had a better voiding symptoms than the control group six months after the surgery,The present study showed that the instillation of hyaluronic acid into the urethra during visualized internal urethrotomy didn’t significantly reduced the recurrence of urethral stricture after the operation although the number of patients who had recurrence after hyaluronic acid instillation were less than recurrence rate in the control group. The hyaluronic acid had no observed side effects and helped to improve the pain and quality of life after the surgery. Conclusion The instillation of hyaluronic into the urethra during VIU reduced postoperative pain and improved voiding symptoms in the study group , but it didn’t significantly reduce the recurrence of urethral stricture after the operation. we suggest that a large-scale, randomized controlled trial be conducted in a larger number of patients with long-term follow-up .

Effect of intraurethral captopril gel on the recurrence of urethral stricture after direct vision internal urethrotomy: Phase II clinical trial

2007 ◽  
Vol 14 (3) ◽  
pp. 203-208 ◽  
Author(s):  
Mehdi Shirazi ◽  
Abdolaziz Khezri ◽  
Soleiman Mohammadi Samani ◽  
Ahmad Monabbati ◽  
Javad Kojoori ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Phase Ii ◽  
Urethral Stricture ◽  
Phase Ii Clinical Trial ◽  
Direct Vision ◽  
Internal Urethrotomy

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 Outcomes of Direct Vision Internal Urethrotomy for Bulbar Urethral Strictures: Technique Modification with High Dose Triamcinolone Injection

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Rishi Modh ◽  
Peter Y. Cai ◽  
Alyssa Sheffield ◽  
Lawrence L. Yeung
Keyword(s):  
Corticosteroid Injection ◽  
Direct Vision ◽  
High Dose ◽  
Internal Urethrotomy ◽  
High Dose Corticosteroid ◽  
Urethral Strictures ◽  
Significant Difference ◽  
Triamcinolone Injection ◽  
Dose Corticosteroid

Objective. To evaluate the recurrence rate of bulbar urethral strictures managed with cold knife direct vision internal urethrotomy and high dose corticosteroid injection.Methods. 28 patients with bulbar urethral strictures underwent direct vision internal urethrotomy with high dose triamcinolone injection into the periurethral tissue and were followed up for recurrence.Results. Our cohort had a mean age of 60 years and average stricture length of 1.85 cm, and 71% underwent multiple previous urethral stricture procedures with an average of 5.7 procedures each. Our technique modification of high dose corticosteroid injection had a recurrence rate of 29% at a mean follow-up of 20 months with a low rate of urinary tract infections. In patients who failed treatment, mean time to stricture recurrence was 7 months. Patients who were successfully treated had significantly better International Prostate Symptom Scores at 6, 9, and 12 months. There was no significant difference in maximum flow velocity on Uroflowmetry at last follow-up but there was significant difference in length of follow-up (p=0.02).Conclusions. High dose corticosteroid injection at the time of direct vision internal urethrotomy is a safe and effective procedure to delay anatomical and symptomatic recurrence of bulbar urethral strictures, particularly in those who are poor candidates for urethroplasty.

Penile urethral stricture disease

2018 ◽  
Vol 12 (2) ◽  
pp. 145-157
Author(s):  
Marco Spilotros ◽  
Suzie Venn ◽  
Paul Anderson ◽  
Tamsin Greenwell
Keyword(s):  
Urethral Stricture ◽  
Lichen Sclerosus ◽  
Corpus Spongiosum ◽  
Hypospadias Repair ◽  
Internal Urethrotomy ◽  
Level Of Evidence ◽  
Urethral Stricture Disease ◽  
Urethral Strictures ◽  
Considerable Cost ◽  
The Uk

Patients affected by a urethral stricture account for a considerable cost to all healthcare systems. The estimated prevalence of all urethral stricture in the UK is 10/100,000 men during youth, increasing to about 40/100,000 by age 65 years and to more than 100/100,000 thereafter. A penile urethral stricture is a narrowing of the lumen of the urethra due to ischaemic fibrosis of the urethral epithelium and/or spongiofibrosis of the corpus spongiosum occurring within the penile urethra. Its aetiology is largely idiopathic but other important causes are failed hypospadias repair and lichen sclerosus, which account for 60% of all cases. Strictures of the anterior urethra account for 92% of cases: bulbar strictures are more frequent (46.9%), followed by penile (30.5%) and combined bulbar/penile (9.9%), that is, 40.4% of all men presenting with stricture will have a penile urethral stricture alone or in combination with a bulbar urethral stricture. There are several options for the treatment of penile urethral strictures ranging from less invasive treatments, including urethral dilatation and direct vision internal urethrotomy, to more complex augmentation graft and flap urethroplasty. The aim of the present review is to describe the aetiology and epidemiology of anterior urethral strictures and the available options reported in literature for their treatment. Level of evidence: 1a

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.

scholarly journals Experience of 138 Transurethral Urethrotomy With Holmium:YAG Laser

2019 ◽  
Vol 10 (2) ◽  
pp. 104-107 ◽  
Author(s):  
Morteza Fallah Karkan ◽  
Mohammad Reza Razzaghi ◽  
Hossein Karami ◽  
Saleh Ghiasy ◽  
Ali Tayyebiazar ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Recurrence Rate ◽  
Urethral Stricture ◽  
Previous History ◽  
Operation Time ◽  
Success Rates ◽  
Urethral Strictures ◽  
Post Operation ◽  
The Mean ◽  
Stricture Recurrence

Introduction: Many valid option modalities are available for the management of urethral stricture disease (USD), such as internal urethrotomy which has the success rates of 33%–60%. The aim of this study was to assess the outcome of holmium: YAG (Ho: YAG) laser urethrotomy (HLU). Methods: One hundred thirty-eight patients with urethral stricture with the mean age of 48±3.03 years old treated by HLU from March 2011 to August 2017. The main purpose of this investigation was to evaluate mean operation time, stricture recurrence rate and post-operation Qmax and complications of transurethral HLU. Results: The most common cause of USD was trauma in 82 (59.4%) patients. Mean laser operation time, mean hospital stay and mean postoperative duration of catheterization were 23.08 ± 9.1 minutes, 19.02 ± 10.7 hours and 10.3 ± 1.05 days respectively. The mean Qmax was 8.3 ± 2.07 mL/s before surgery and 16 ±3.1 mL/s afterward. At the end of 12 months follow-up, a total of 37 (26.8%) patients developed recurrence of the stricture. Patients with posterior, longer urethral strictures and previous history of interventions have more recurrence rate of the stricture. Conclusion: HLU is minimally invasive and seems to be an effective and safe management option for primary, short, urethral strictures. The hospital stay is remarkably short and complications are negligible.

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