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Interventional urethral balloon dilatation before endoscopic visual internal urethrotomy for post-traumatic bulbous urethral stricture:A case report

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World Journal of Clinical Cases 2022年第34期10卷 12787-12792页

作者： Ji Yong Ha Mu Sook Lee Department of Urology Keimyung University Dongsan HospitalKeimyung University School of MedicineDaegu 42601South Korea Department of Radiology Keimyung University Dongsan HospitalKeimyung University School of MedicineDaegu 42601South Korea

BACKGROUND While several treatment options are available for pediatric urethral strictures,the appropriate treatment must be based on several *** endoscopic visual internal urethrotomy(EVIU)could be a first-line treatment option for short pediatric urethral strictures,it is not feasible if the urethroscope cannot pass through the stricture ***,we present a pediatric case of severe posttraumatic bulbous urethral stricture that was successfully treated by EVIU after securing the urethral route via interventional balloon *** SUMMARY A 12-year-old boy presented at our outpatient clinic with the inability to *** had sustained a straddle injury three months *** post-void residual urine volume was 644 mL,and retrograde urethrography confirmed severe stricture of the bulbous *** was planned;however,the first attempt to treat the stricture failed because the urethroscope could not pass through the stricture *** urethral route was subsequently secured via balloon dilatation of the stricture,which was performed in collaboration with specialists from the department of interventional *** urethroscope was then able to pass,and the repeat EVIU was *** Interventional urethral balloon dilatation before EVIU may help secure the urethral route in the treatment of pediatric urethral strictures.

关键词： urethral stricture Endoscopic visual internal urethrotomy Urethroplasty urethral balloon dilatation Interventional radiology Case report

Long-term outcomes of urethral balloon dilation for anterior urethral stricture: A prospective cohort study

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Asian Journal of Urology 2024年第3期11卷 480-485页

作者： Ahmed M.Abdel Gawad Abhijit Patil Abhishek Singh Arvind P.Ganpule Ravindra B.Sabnis Mahesh R.Desai Department of Urology Muljibhai Patel Urological HospitalNadiadIndia Department of Urology Faculty of MedicineAl-Azhar UniversityDamiettaEgypt

Objective:To prospectively follow up a cohort of anterior urethral stricture disease patients managed with balloon dilation(BD)for 3 years to evaluate the long-term outcomes and to study factors that contribute to ***:This study included men who had urethral BD for significant anterior urethral stricture disease between January 2017 and March *** about the patient age,stricture characteristics,and recurrence date were recorded,along with information on postoperative indwelling catheter use and operative ***,information about the self-calibration procedure was collected and where available,free flow(FF)measurements during the follow-up period were recorded and *** was defined as a lack of symptoms and acceptable FF rates(maximum flow rate>12 mL/s).Results:The final analysis was conducted on 187 *** mean follow-up period was 37 *** long-term overall success rate at the end of our study was 66.8%.Our recurrence rate was 7.4%at 12 months,24.7%at 24 months,and reached 33.2%at the end of our *** time to recurrence ranged from 91 days to 1635 days,with a mean of 670 *** stricture-free survival was significantly shorter with lengthy peno-bulbar(p=0.031)and multiple strictures(p=0.015),and in the group of patients who were not committed to self-calibration protocol(pstricture-free survival and FF parameters.

关键词： Balloon dilation Internal urethrotomy Recurrence Self-calibration urethral stricture

Analysis of the urethral stricture score and patient-related factors as predictors of outcomes following oral mucosal graft urethroplasty

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Asian Journal of Urology 2024年第3期11卷 473-479页

作者： Nikita Shrivastava Rahul Jena Deepak Prakash Bhirud Mahendra Singh Gautam Ram Choudhary Arjun Singh Sandhu Department of Urology All India Institute of Medical SciencesJodhpurRajasthanIndia

Objective:The complexity of urethral strictures can predict outcomes following *** previously described urethral stricture score(U score)considered only stricture-related factors to grade the complexity of urethral strictures and to predict recurrence post urethroplasty,but not considered patient-related factors for the *** aimed to study the correlation of both of these factors to the outcomes of oral mucosal graft ***:We retrospectively reviewed data of 101 patients who underwent oral mucosal graft urethroplasty in our institute with a minimum follow-up of 6 *** patient characteristics and stricture-related parameters were *** U score was calculated for all patients which consisted of the length,location,number,and etiology of *** and multivariate Cox proportional hazard regression models were used to determine significant risk factors of ***:The mean follow-up of patients was 15 *** was seen in 28 patients and the mean time for detection of recurrence was 8 months of *** Charlson Comorbidity Index,history of previous intervention,length of strictures,location of strictures,number of strictures,history of smoking,and etiology were independent predictors of recurrence following *** on these parameters,we formulated the modified U score(MU score).The scores ranged from 0 to 6 and a score of>2 was found to be predictive of *** comparing receiver operating characteristic curves for both scores by the DeLong test,the MU score had larger area under the curve than the U ***:The MU scoring system is the first of its kind attempt taking into consideration both patient-and stricture-related factors to predict recurrence following oral mucosal graft urethroplasty.

关键词： urethral stricture urethral stricture score Recurrence Urethroplasty

Current trends in urethral stricture management

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Asian Journal of Urology 2014年第1期1卷 46-54页

作者： Christopher J.Hillary Nadir I.Osman Christopher R.Chapple Department of Urology Royal Hallamshire HospitalSheffieldUK

The recent International Consultation on Urological Disease(ICUD)panel 2010 confirmed that a urethral stricture is defined as a narrowing of the urethra consequent upon ischaemic spongiofibrosis,as distinct from sphincter stenoses and a urethral disruption *** possible,an anastomotic urethroplasty should be performed because of the higher success rate as compared to augmentation *** is some debate currently regarding the critical stricture length at which an anastomotic procedure can be used,but clearly the extent of the spongiofibrosis and individual anatomical factors(the length of the penis and urethra)are important,the limitation for this being extension of dissection beyond the peno-scrotal junction and the subsequent production of *** recently,there has been interest in whether to excise and anastomose or to carry out a stricturotomy and reanastomosis using a Heineke-Miculicz *** urethroplasty has evolved towards the more extensive use of oral mucosa grafts as compared to penile skin flaps,as both flaps and grafts have similar efficacy and certainly the use of either dorsal or ventral positioning seems to provide comparable *** is important that the reconstructive surgeon is well versed in the full range of available repair techniques,as no single method is suitable for all cases and will enable the management of any unexpected anatomical findings discovered intra-operatively.

关键词： urethral stricture stricture Lichen sclerosus Pelvic fracture urethral injury Bladder outflow obstruction Urethroplasty Buccal mucosa graft

Investigation of risk factors in the development of recurrent urethral stricture after internal urethrotomy

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World Journal of Clinical Cases 2024年第14期12卷 2324-2331页

作者： Abdullah Gul Ozgur Ekici Salim Zengin Deniz Barali Tarik Keskin Department of Urology University of Health SciencesBursa Yüksekİhtisas Education and Research HospitalBursa 16100Türkiye Department of Urology University of Health SciencesBursa City HospitalBursa 16000Türkiye

BACKGROUND urethral stricture is a condition that often develops with trauma and results in narrowing of the urethral *** endoscopic methods are mostly used in its treatment,it has high recurrence ***,open urethroplasty is recommended after unsuccessful endoscopic *** To investigate the risk factors associated with urethral stricture *** The data of male patients who underwent internal urethrotomy for urethral stricture between January 2017 and January 2023 were retrospectively *** data,comorbidities,preoperative haemogram,and biochemical values obtained from peripheral blood and operative data were *** were divided into two groups in terms of recurrence development;recurrence and *** recorded data were compared between the two *** A total of 303 patients were included in the *** mean age of the patients was 66.6±13.6 *** mean duration of recurrence development was 9.63±9.84(min-max:1-39)months in the recurrence *** did not occur in non-recurrence group throughout the follow-up period with an average time of 44.15±24.07(min-max:12-84)*** the comparison of both groups,the presence of diabetes mellitus(DM),hypertension(HT),and multiple comorbidi-ties were significantly higher in the recurrence(+)group(P=0.038,P=0.012,P=0.013).Blood group,postoperative use of non-steroidal anti-inflammatory drugs,preoperative cystostomy,cause of stricture,iatrogenic cause of stricture,location and length of stricture,indwelling urinary cathater size and day of catheter removal did not differ between the two *** statistically significant difference was observed between the two groups in terms of age,uroflowmetric maximum flow rate value,hemo-gram parameters,aspartate aminotransferase(AST),alanine aminotransferase(ALT),fasting blood sugar,creati-nine,glomerular filtration rate,neutrophil-lymphocyte ratio,platelet-lymphocyte ratio,lymphocyte-

关键词： Inflammation Internal urethrotomy Recurrence urethral stricture Urethra

Tunica albuginea versus buccal mucosa graft urethroplasty for anterior urethral stricture: A prospective randomised pilot study

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Asian Journal of Urology 2023年第2期10卷 189-194页

作者： Mohammad Shazib Faridi Vikas Sharma Adittya K.Sharma Rahul Yadav Division of Urology Department of SurgeryHamdard Institute of Medical Sciences&Research and HAHC HospitalNew DelhiIndia Department of Urology Rajiv Gandhi Super Speciality HospitalTahirpurDelhiIndia Department of Urology Apollomedics Super Speciality HospitalLucknowUttar PradeshIndia

Objective:The objective of the study was to compare the outcome of tunica albuginea urethroplasty(TAU)and buccal mucosa graft(BMG)urethroplasty for anterior urethral ***:Thirty patients who met the inclusion criteria were randomised into two groups:TAU(Group A)and BMG urethroplasty(Group B).Surgical outcome was evaluated with pre-and post-operative work-up involving retrograde urethrogram,voiding cystourethrogram,uroflowmetry,and *** were followed up till 1 ***:Mean duration of surgery was statistically significant between two groups(p=0.0005).Maximum urine flow rate was comparable when compared between two groups(p=0.22)but statistically significant when compared pre-and post-operatively(p<0.001).At follow-up of 1 year,the successful outcomes were 80% in Group A and 87%in Group B.A total of five patients who had unsuccessful results required redo *** were minimal in both the ***:TAU provides outcomes equivalent to those of BMG *** has less operative time,easy to perform,and beneficial in patients with poor oral hygiene.

关键词： Buccal mucosa Male urologic surgery Tunica albuginea urethral stricture Urethroplasty

Combined grafts and flaps in urethral stricture repair

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Plastic and Aesthetic Research 2022年第1期9卷 213-224页

作者： Francisco Dávila Tiago Rosito Borko Stojanovic Francisco E.Martins Department of Urology Hospital de Clínicas de Porto AlegreUFRGSPorto Alegre 90035-903Brazil Department of Urology Belgrade Center for Urogenital Reconstructive SurgerySchool of MedicineUniversity of BelgradeBelgrade 11000Serbia Department of Urology School of MedicineUniversity of LisbonCHULNLisbon 1649-028Portugal

Although urethral strictures have been known since antiquity,the surgical management of urethral strictures has undergone a great(re)evolution over the last six decades,both in the perception of the disease and in the surgical repair techniques,always presenting itself as a challenge for the surgeon and *** of urethral stricture disease involving a combination of grafts and flaps consists of a group of complex procedures with specific clinical *** knowledge of these procedures by reconstructive urologists is both necessary and relevant.A thorough understanding of the anatomy,including blood supply,is a crucial proviso for the correct evaluation and successful management of urethral stricture *** discuss the main techniques and indications in combined graft and flap urethroplasties.

关键词： urethral stricture urethral stenosis genital flap penile flap reconstructive urology combined urethral surgery

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

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Journal of Zhejiang University-Science B(Biomedicine & Biotechnology) 2016年第9期17卷 722-727页

作者： Shi-cheng YU Hai-yang WU Wei WANG Li-wei XU Guo-qing DING Zhi-gen ZHANG Gong-hui LI Department of Urology Sir Run Run Shaw HospitalSchool of MedicineZhejiang University

Objectives： We retrospectively reviewed the urethral stricture cases treated in our tertiary center, and assessed the safety and feasibility of the high-pressure balloon dilation （HPBD） technique for anterior urethral stricture Methods： From January 2009 to December 2012, a total of 31 patients with anterior urethral strictures underwent HPBD at our center, while another 25 cases were treated by direct vision internal urethrotomy （DVIU）. Patient de- mographics, stricture characteristics, surgical techniques, and operative outcomes were assessed and compared between the two groups. The Kaplan-Meier survival analysis was applied to evaluate the stricture-free rate for the two surgical techniques. Results： The operation time was much shorter for the HPBD procedure than for the DVIU （（13.19±2.68） min vs. （18.44±3.29） min, P〈0.01）. For the HPBD group, the major postoperative complications as urethral bleeding and urinary tract infection （UTI） were less frequently encountered than those in DVIU （urethral bleeding： 2/31 vs. 8/25, P=0.017; UTI： 1/31 vs. 6/25 P=0.037）. The Kaplan-Meier survival analysis showed that there was no significant difference in stricture-free rate at 36 months between the two groups （P=-0.21, hazard ratio （HR）=0.65, 95% confidence interval （CI）： 0.34 to 1.26）. However, there was a significantly higher stricture-free survival in the HPBD group at 12 months （P=-0.02, HR=0.35, 95% CI： 0.14 to 0.87）, which indicated that the stricture recurrence could be delayed by using the HPBD technique. Conclusions： HPBD was effective and safe and it could be considered as an alternative treatment modality for anterior urethral stricture disease.

关键词： urethral stricture High-pressure balloon dilation Urethrotomy

Safety and efficacy of laser and cold knife urethrotomy for urethral stricture

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Chinese Medical Journal 2010年第12期123卷 1589-1595页

作者： JIN Yao LI Hong JIANG Li-hai WANG Li WANG Kun-jie Department of Urology West China Hospital Sichuan University Chengdu Sichuan 610041 China Chinese Evidence-based Medicine Centre West China Hospital Sichuan University Chengdu Sichuan 610041 China

Background Endoscopic treatment for urethral stricture, including cold knife and laser, poses a major challenge to clinical practice. Both the benefits and drawbacks of these two treatments remain controversial. This article aimed to compare the efficacy and safety of laser and cold knife urethrotomy for urethral stricture. Methods We searched PubMed （1966-2009）, Embase （1980-2009）, Cochrane Central Register of Controlled Trials （CCRCT, 2009 No.l） and Chinese Biomedical Literature Database （CBM） for laser and cold knife urethrotomy as treatment for male urethral stenosis, looking in the English literatures. Two reviewers independently screened the literatures and extracted information. Chi-square test was used for statistical analysis with SPSS15.0. Results A total of 44 articles, including of 3230 cases was retrieved. Success rate of patients treated with laser was 74.9% compared with 68.5% for cold knife, with very similar clinical results despite a statistically significant difference （P=-0.004）. The trend in success rate at a different follow-up time was similar between the two groups. No significant difference in success rate was found between the groups of repeat operation for recurrence cases, first P=0.090 and second P=0.459. The shorter the stricture length was （〈1 cm）, the higher the success rate was （P 〈0.0001）. No significant difference in success rate between the laser and cold knife groups was found in neither bulbar nor membranous urethra, bulbar P=0.660 and membranous P=0.477. The rates of urinary incontinence, urinary extravasation, and urinary tract infection showed no significant difference （P=-0.259, P=0.938, P=-0.653, respectively）. Conclusions Success rates for laser and cold knife were very similar despite being statistically different, with the groups having a similar trend in success rates at different follow-up time. stricture location and history of endoscopic intervention did impact treatment outcome but was not significantly different. T

关键词： urethral stricture urologic surgical procedures, treatment outcome