Management of urethral stricture: High‐pressure balloon dilation versus optical internal urethrotomy

2017 ◽  
Vol 11 (2) ◽  
pp. O34-O37 ◽  
Author(s):  
Yohei Kumano ◽  
Takashi Kawahara ◽  
Taku Mochizuki ◽  
Daiji Takamoto ◽  
Teppei Takeshima ◽  
...  
Keyword(s):  
High Pressure ◽  
Urethral Stricture ◽  
Balloon Dilation ◽  
Internal Urethrotomy ◽  
Optical Internal Urethrotomy

Evaluation of Holmium Laser versus Cold Knife in Optical Internal Urethrotomy for the Management of Urethral Stricture

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Wael Ali Maged ◽  
Mohamed Ahmed Gamal ◽  
Samuel Fayek Tawfeles
Keyword(s):  
Urethral Stricture ◽  
Treatment Effectiveness ◽  
Holmium Laser ◽  
Military Hospital ◽  
University Hospitals ◽  
Internal Urethrotomy ◽  
Cold Knife ◽  
Group 10 ◽  
Optical Internal Urethrotomy

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.

scholarly journals Efficacy of Optical Internal Urethrotomy and Intralesional Injection of Vatsala-Santosh PGI Tri-Inject (Triamcinolone, Mitomycin C, and Hyaluronidase) in the Treatment of Anterior Urethral Stricture

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Santosh Kumar ◽  
Nitin Garg ◽  
Shrawan Kumar Singh ◽  
Arup Kumar Mandal
Keyword(s):  
Success Rate ◽  
Mitomycin C ◽  
Recurrence Rate ◽  
Urethral Stricture ◽  
Clinical History ◽  
Therapeutic Modality ◽  
Intralesional Injection ◽  
Internal Urethrotomy ◽  
Retrograde Urethrogram ◽  
Optical Internal Urethrotomy

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.

scholarly journals Treatment of Short Segment Anterior Urethral Stricture: Optical Internal Urethrotomy (OIU) Alone and OIU with Triamcinolone

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 ◽  
...  
Keyword(s):  
Triamcinolone Acetonide ◽  
Urethral Stricture ◽  
Therapeutic Modality ◽  
Control Group ◽  
Internal Urethrotomy ◽  
Triamcinolone Injection ◽  
Group A ◽  
Group B ◽  
Optical Internal Urethrotomy

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

scholarly journals Results of Buccal Mucosal Graft Urethroplasty in Management of Anterior Urethral Stricture – Experience in a Single Center

2020 ◽  
Vol 22 (2) ◽  
pp. 128-131
Author(s):  
Mohammad Abdul Aziz ◽  
Shafiqur Rahman ◽  
Mirza Mahbubul Hasan
Keyword(s):  
Success Rate ◽  
General Hospital ◽  
Urethral Stricture ◽  
Buccal Mucosa ◽  
Single Center ◽  
Internal Urethrotomy ◽  
Exclusion Criteria ◽  
Urethral Strictures ◽  
Buccal Mucosal Graft ◽  
Optical Internal Urethrotomy

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

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

scholarly journals The Outcome of Delayed One Stage Urethroplasty in Post-Traumatic Prostato-Membranous Urethral Stricture : A Retrospective Study of 50 Cases

1970 ◽  
Vol 25 (3) ◽  
pp. 130-138
Author(s):  
Zahid Hassan Bhuiyan ◽  
M Fakhrul Islam ◽  
KMH Tawhid ◽  
Mamoon Siraj
Keyword(s):  
Retrospective Study ◽  
Urethral Stricture ◽  
Perineal Approach ◽  
Internal Urethrotomy ◽  
Suprapubic Cystostomy ◽  
Medical College ◽  
One Stage ◽  
Urethral Fistula ◽  
Post Traumatic ◽  
Optical Internal Urethrotomy

We have reviewed the result of delayed one stage urethroplasty through perineal approach in post traumatic prostato-membranous urethral stricture with associated pelvic fracture in a retrospective study. The place of study is Bangladesh Medical College Dhaka. The study period was from Nov'01 to Aug'04. The sample size was 50. Thirty two cases presented with post-traumatic stricture of urethra ( PTSU ) with suprapubic cystostomy (SPC). The rest 18 cases were complicated and presented with recurrent stricture with associated periurethral abscess, suprapubic and perineal urethral fistula or thigh urinoma. These cases were managed initially by suprapubic cystostomy (SPC) and adequate local care before re-admission for definitive procedure. All cases were underwent delayed one stage urethroplasty through perineal approach after > 3 months of SPC and were followed carefully for > 06 months in each case. The outcome in 42 cases were excellent; required no treatment. In 06 cases the result was good requiring 01 - 03 sessions of optical internal urethrotomy (OIU). Poor result was observed in 02 cases, managed by > 3 sessions of OIU followed by intermittent self dilatation (ISD). No patient needed reoperation. The overall result is excellent. (J Bangladesh Coll Phys Surg 2007; 25 : 130-138)

Comparative Study Of Optical Internal Urethrotomy Versus Anastomotic Urethroplasty For Short Segment Bulbar Urethral Stricture

2020 ◽  
Vol 16 (1) ◽  
pp. 21-25
Author(s):  
Asm Shafiul Azam ◽  
Akm Kawsar Habib ◽  
Sm Mahbub Alam ◽  
Md Habibur Rahman ◽  
Md Abdus Salam ◽  
...  
Keyword(s):  
Urethral Stricture ◽  
Internal Urethrotomy ◽  
Short Segment ◽  
College Hospital ◽  
Exact Probability ◽  
Urethral Strictures ◽  
Significant Difference ◽  
Urinary Stream ◽  
Optical Internal Urethrotomy ◽  
Anastomotic Urethroplasty

Objective: This study was conducted to compare the outcome of anastomotic urethroplasty with that of traditional optical internal urethrotomy in the treatment of short-segment bulbar urethral stricture. Methods: This comparative clinical study was conducted in the Department of Urology, Dhaka Medical College Hospital over a period 1 year from January 2007 to December 2008. A total of 50 patients with short-segment (< 2 cm) bulbar urethral strictures were consecutively included in the study. The test statistics used to analyses the data were Fisher’s Exact Probability Test, Student’s t-Test. For all analytical tests, the level of significance was set at 0.05 and p < 0.05 was considered significant. Results: About one-quarter (24%) of patients in OI Urethrotomy group experienced bleeding, 4% epididymitis and another 4% incontinence. In contrast, 8% of patients in Anastomotic Urethroplasty group complained of periurethral leakage, 8% fever and another 8% wound infection. Apart from bleeding, all the complications were almost homogeneously distributed between groups.Six (24%) of patients in OI Urethrotomy Group exhibited narrow urinary stream at month 3, as opposed to none in Anastomotic Urethroplasty Group (p = 0.001). Nearly 30% of patients in OI Urethrotomy Group had narrow urinary stream at month 6 compared 4% in Anastomotic Urethroplasty Group (p = 0.024). Of the 25 patients in OI Urethrotomy Group, 1(4%) developed UTI at month 3 and 5(20%) at month 6. None of the patients in Anastomotic Urethropasty Group developed UTI. There was significant difference between groups in terms of UTI at month 6 (p = 0.025).The recurrence rate of stricture in OI Urethrotomy was 24% (6 out of 25 patients) at month 3. However, none in Anastomotic Urethroplasty Group had history of recurrence of stricture (p = 0.011). At baseline the mean uroflowmetry was 5.5 ml/sec in both groups which immediately increased to 25.3 ± 2.6 ml/sec and 23.9 ± 2.2 ml/sec in OI urethrotomy and Anastomotic Urethroplasty groups respectively and then dropped to 18.4 ± 6.3 ml/sec and 20.2 ± 2.6 ml/sec in OI Urethrotomy and Anastomotic Urethroplasty groups respectively at month 3 and to 17.8 ± 6.4 ml/sec and 19.6 ± 2.6 ml/sec respectively at month 6. Conclusion: This study concludes that Anastomotic Urethroplasty is an effective and satisfactory technique for the treatment of short-segment bulbar urethral stricture. Bangladesh Journal of Urology, Vol. 16, No. 1, Jan 2013 p.21-25

scholarly journals High-pressure balloon dilation for male anterior urethral stricture: single-center experience

2016 ◽  
Vol 17 (9) ◽  
pp. 722-727 ◽  
Author(s):  
Shi-cheng Yu ◽  
Hai-yang Wu ◽  
Wei Wang ◽  
Li-wei Xu ◽  
Guo-qing Ding ◽  
...  
Keyword(s):  
High Pressure ◽  
Urethral Stricture ◽  
Balloon Dilation ◽  
Single Center ◽  
Single Center Experience
Sign in / Sign up

Export Citation Format

Share Document