scholarly journals Outcome of urethral strictures treated by endoscopic urethrotomy and urethroplasty

2014 ◽  
Vol 8 (1-2) ◽  
pp. 16 ◽  
Author(s):  
Javier Tinaut-Ranera ◽  
Miguel Angel Arrabal-Polo ◽  
Sergio Merino-Salas ◽  
Mercedes Nogueras-Ocaña ◽  
Victor Lopez-Leon ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Urethral Stricture ◽  
Previous Treatment ◽  
Urinary Flow ◽  
The Past ◽  
Urethral Strictures ◽  
High Surgical Risk ◽  
Endoscopic Urethrotomy ◽  
Male Patients ◽  
Maximum Urinary Flow

Introduction: We analyze the outcomes of patients with urethral stricture who underwent surgical treatment within the past 5 years.Methods: This is a retrospective study of male patients who underwent surgery for urethral stricture at our service from January 2008 to June 2012. We analyzed the comorbidities, type, length and location of the stricture and the surgical treatment outcome after endoscopic urethrotomy, urethroplasty or both.Results: In total, 45 patients with a mean age of 53.7 ± 16.7 years underwent surgical treatment for urethral stricture. Six months after surgery, 46.7% of the patients had a maximum urinary flow greater than 15 mL/s, whereas 87.3% of the patients exhibited no stricture by urethrography after the treatment. The success rate in the patients undergoing urethrotomy was 47.8% versus 86.4% in those undergoing urethroplasty (p = 0.01). Twenty percent of the patients in whom the initial urethrotomy had failed subsequently underwent urethroplasty, thereby increasing the treatment success.Conclusion: In most cases, the treatment of choice for urethral stricture should be urethroplasty. Previous treatment with urethrotomy does not appear to produce adverse effects that affect the outcome of a urethroplasty if urethrotomy failed, so urethrotomy may be indicated in patients with short strictures or in patients at high surgical risk.

scholarly journals COMPARISON OF EFFICACY AND SAFETY SILODOSIN 8 MG ONCE DAILY AND SILODOSIN 4 MG TWICE DAILY IN BPH PATIENTS WITH LUTS

2019 ◽  
Vol 26 (1) ◽  
Author(s):  
Ramzie Nendra Diansyah ◽  
Johan Renaldo ◽  
Wahjoe Djatisoesanto ◽  
Lukman Hakim
Keyword(s):  
Adverse Events ◽  
Side Effect ◽  
Similar Efficacy ◽  
Common Adverse Event ◽  
Common Side Effect ◽  
Urinary Flow ◽  
Once Daily ◽  
Significant Difference ◽  
Male Patients ◽  
Maximum Urinary Flow

Objective: This study was aimed to compare the efficacy and side effect of silodosin 8mg once daily and silodosin 4mg twice daily in BPH-LUTS patients after 4 and 12 weeks. Material & Methods: Single blind randomized controlled trials in 60 male patients aged ≥45 years with BPH-LUTS from July 2017 to October 2017 was divided into groups who received 8mg of silodosin once daily and those who received 4mg of silodosin twice daily. Efficacy and adverse events were evaluated after 4 and 12 weeks of treatment. Results:  There was no significant difference of mean age of the two groups was 67.93 ± 6.49 years and 69.07 ± 6.28 years respectively (p 0.49). Both doses of this drug decreased the International Prostate Symptom Score (IPSS) and significantly increased the maximum urinary flow (Qmax) (p<0.05) but there was no significant differences between the two groups (p>0.05). Ejaculation disorder was the most common side effect in all groups (6.7% and 5%) and there was no significant difference between the two groups (p>0.05). Conclusion: The administration of 8mg of once daily silodosin has similar efficacy as 4mg twice daily silodosin. There were no adverse events differences in the two groups. Ejaculation disorder is the most common adverse event of silodosin administration.

scholarly journals Rekanalizacija striktura uretre privremenim prekrivenim biokompatibilnim metalnim endoprotezama nove generacije

2007 ◽  
Vol 54 (3) ◽  
pp. 123-127 ◽  
Author(s):  
Z. Markovic ◽  
B.B. Markovic ◽  
C. Tulic ◽  
J. Hadzi-Djokic ◽  
V. Stojanovic ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Urethral Stricture ◽  
Stent Placement ◽  
Clinical Issue ◽  
Urethral Strictures ◽  
Therapeutic Algorithm ◽  
Common Etiology ◽  
Previously Treated ◽  
First Time

The male urethral stricture treatment is actual clinical issue with its resolution being increasingly frequently based on application of minimum invasive therapeutic interventional uroradiology methods. Since the methodology is applied over the last two decades, the most reasonable therapeutic algorithm has not been defined yet with respect to the correlation with the contemporary surgical treatment. The results of application of the temporary covered self-expandable nitinol Allium stents, which have been applied for the first time ever at our Institution in October 2003. Over the last 3 years, the method was applied in 40 males, averagely aged 54 years with urethral strictures previously treated by urological methods. In four cases, stent placement was performed after endourethral incision. The most common etiology of the stricture was the posttraumatic (55 %), post-inflammatory (32%) and iatrogenic (10%). In all the cases, stents were removed 12-14 months after their insertions. The results are evaluated using uroflowmetry and urethrocystography, revealing in 85% of the cases permanent recanalization free of dysuric complaints. Development of a stricture on the anterior stent end was evidenced in 15% of the cases.

scholarly journals Surgical treatment of urethral tuberculosis in men – history and present (literature review)

2021 ◽  
Vol 6 (4) ◽  
pp. 220-229
Author(s):  
A. A. Volkov ◽  
O. N. Zuban ◽  
M. N. Reshetnikov ◽  
D. V. Plotkin ◽  
E. M. Bogorodskaya
Keyword(s):  
Surgical Treatment ◽  
Literature Review ◽  
Urethral Stricture ◽  
Extrapulmonary Tuberculosis ◽  
Specific Therapy ◽  
Promising Direction ◽  
Clinical Recovery ◽  
Urine Diversion ◽  
Urethral Strictures ◽  
Urethral Dilation

The literature review provides data on tuberculosis of the urethra in men. This disease is rarely recorded, as a rule, at the stage of formation of the urethral stricture, which can develop many years after the onset of the disease. Urethral tuberculosis is usually secondary to other localizations of extrapulmonary tuberculosis, such as tuberculosis of the prostate, penis, kidney, and bladder, but there are also isolated forms of this disease. The most common symptoms of urethral tuberculosis are the presence of strictures, skin-urethral and recto-prostatic fistulas, and purulent urethritis. Almost always, with this disease, conservative specific therapy was carried out, which in some cases made it possible to completely eliminate the symptoms and ensure the patient’s clinical recovery. Tuberculous urethral strictures are operated on according to generally accepted rules, but there is no single algorithm for the surgical treatment of strictures of this etiology, often limiting itself only to urine diversion or urethral dilation. Of the urethroplasty, the most commonly used end-to-end urethral anastomosis. In our opinion, a promising direction is the use of various grafts for the surgical treatment of this disease.

scholarly journals One-stage buccal two-flap urethroplasty using the Kulkarni technique for extended anterior urethral strictures

2020 ◽  
Vol 8 (4) ◽  
pp. 44-52
Author(s):  
M. I. Katibov ◽  
M. M. Alibekov ◽  
Z. M. Magomedov ◽  
A. M. Abdulkhalimov ◽  
V. G. Aydamirov
Keyword(s):  
Urethral Stricture ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Disease Recurrence ◽  
Urinary Flow ◽  
One Stage ◽  
Urethral Strictures ◽  
Prospective Control ◽  
Onlay Technique

Introduction. The problem of extended urethral strictures treatment remains relevant due to the complexity of the supervision of such patients and the high frequency of disease recurrence after surgical treatment.Purpose of the study. Evaluation of the effectiveness of one-stage buccal urethroplasty according to the Kulkarni technique using two flaps for extended anterior urethral strictures.Materials and methods. The study included 18 men with an extended anterior urethral stricture, who underwent buccal urethroplasty by perineal access using the Kulkarni dorsolateral onlay technique using two flaps from January 2018 to March 2020, and a postoperative follow-up period of at least 6 months. The study was prospective. Control examination was carried out 3, 6, 12, 18 and 24 months after surgery. The criteria for the recurrence of urethral stricture were the presence of complaints of deterioration in the quality of urination in combination with a decrease in the maximum urinary flow rate of less than 12 ml/sec and the presence of residual urine in an amount of more than 100 ml, as well as the need to perform any surgical intervention to restore the normal passage of urine.Results. The age of the patients ranged from 32 to 72 years (median 58 years). The length of the stricture ranged from 6 to 11 cm (median, 8 cm). The stricture was localized in the penile segment in 11 (61.1%) cases and the penile and bulbar urethra in 7 (38.9%) cases simultaneously. An iatrogenic cause of urethral stricture occurred in 11 (61.1) patients, idiopathic in 5 (27.8%) patients and inflammatory in 2 (11.1%) patients. The stricture was primary in 12 (66.7%) cases and recurrent in 6 (33.3%). Spontaneous urination was preserved in 6 (33.3%) patients, cystostomy existed in 12 (66.7%) patients. The follow-up period after surgery ranged from 3 to 24 months (median - 12 months). Recurrence of urethral stricture was noted in 3 (16.7%) cases. The use of this technique for recurrent forms of the urethral stricture (recurrence after the previous urethroplasty) is the most significant risk factor for treatment failure. 1 (5.6%) case of erectile dysfunction and stress urinary incontinence has taken place of the late postoperative complications.Conclusions. The Kulkarni operation using two buccal flaps for extended strictures of the anterior urethra allows to achieve high rates of efficacy and safety of a treatment, however, the risk of failure increases significantly when used for the treatment of recurrent types of strictures. 

scholarly journals Retrograde urethrography, sonouretrography and magnetic resonance urethrography in evaluation of male urethral strictures. Should the novel methods become the new standard in radiological diagnosis of urethral stricture disease?

2021 ◽  
Author(s):  
Frankiewicz Mikolaj ◽  
Markiet Karolina ◽  
Kozak Oliwia ◽  
Krukowski Jakub ◽  
Kałużny Adam ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Urethral Stricture ◽  
Imaging Techniques ◽  
Accurate Method ◽  
Perfect Agreement ◽  
Urethral Stricture Disease ◽  
Urethral Strictures ◽  
Additional Imaging ◽  
Male Patients ◽  
Diagnostic Modalities

Abstract Purpose To verify which of the diagnostic modalities: Voiding cystouretrography (VCUG), Sonouretrography (SUG) or Magnetic resonance uretrography (MRU) is the most accurate in the assessment of urethral strictures in males and in what cases the application of novel imaging techniques benefits most. Methods 55 male patients with a diagnosis of urethral stricture, were enrolled in this prospective study. Initial diagnosis of urethral stricture was based on anamnesis, uroflowmetry and VCUG. Additional imaging procedures—SUG and MRU were performed before the surgery. Virtual models and 3D printed models of the urethra with the stricture were created based on the MRU data. Exact stricture length and location were evaluated by each radiological method and accuracy was verified intraoperatively. Agreement between SUG and MRU assessments of spongiofibrosis was evaluated. MRU images were independently interpreted by two radiologists (MRU 1, MRU 2) and rater reliability was calculated. Results MRU was the most accurate [(95% CI 0.786–0.882), p < 0.0005] with an average overestimation of 1.145 mm (MRU 1) and 0.727 mm (MRU 2) as compared with the operative measure. VCUG was less accurate [(95% CI 0.536–0.769), p < 0.0005] with an average underestimation of 1.509 mm as compared with operative measure. SUG was the least accurate method [(95% CI 0.510–0.776), p < 0.0005] with an average overestimation of 2.127 mm as compared with the operative measure. There was almost perfect agreement of MRU interpretations between the radiologists. Conclusions VCUG is still considered as a ‘gold standard’ in diagnosing urethral stricture disease despite its limitations. SUG and MRU provide extra guidance in preoperative planning and should be considered as supplemental for diagnosing urethral stricture. Combination of VCUG and SUG may be an optimal set of radiological tools for diagnosing patients with urethral strictures located in the penile urethra. MRU is the most accurate method and should particularly be considered in cases of post-traumatic or multiple strictures and strictures located in the posterior urethra.

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