Opinion: Endoscopic Urethrotomy

Cavalcanti, André G.; Fiedler, Gustavo

doi:10.1590/s1677-5538.ibju.2015.04.03

Cited by 8 publications

(5 citation statements)

References 19 publications

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“…2 Depending upon the characteristics of the stricture (i.e., location, etiology, size, and density of spongiofibrosis), a number of invasive treatments have been performed, 1 including urethroplasty, balloon dilation, cold knife incision, and laser urethrotomy. [3][4][5][6][7][8] Currently, the most popular treatment method of urethral strictures is open reconstructive surgery of the urethra (also called urethroplasty). 6 Yet, in spite of a success rate of ∼97%, the procedure is highly invasive, expensive, and related to considerable complications.…”

Section: Introductionmentioning

confidence: 99%

“…[5][6][7] In the case of laser ablation, the delivery of laser light through an end-firing fiber can coagulate or ablate the target tissue for scar removal, but the forward light emission often limits the extent of treatment areas. [5][6][7][8] Laser-induced interstitial thermotherapy (LITT and also called interstitial LA) 9 has been investigated and used as a minimally invasive method for treating different types of tumors in liver, brain, head, neck, and other tissues in terms of thermal coagulation. [10][11][12][13][14] LITT delivers laser light through a miniature optical fiber percutaneously to the point of treatment.…”

Section: Introductionmentioning

confidence: 99%

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Real-time temperature monitoring with fiber Bragg grating sensor during diffuser-assisted laser-induced interstitial thermotherapy

et al. 2017

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High-sensitivity temperature sensors have been used to validate real-time thermal responses in tissue during photothermal treatment. The objective of the current study was to evaluate the feasible application of a fiber Bragg grating (FBG) sensor for diffuser-assisted laser-induced interstitial thermotherapy (LITT) particularly to treat tubular tissue disease. A 600 - ? m core-diameter diffuser was employed to deliver 980-nm laser light for coagulation treatment. Both a thermocouple and a FBG were comparatively tested to evaluate temperature measurements in ex vivo liver tissue. The degree of tissue denaturation was estimated as a function of irradiation times and quantitatively compared with light distribution as well as temperature development. At the closer distance to a heat source, the thermocouple measured up to 41% higher maximum temperature than the FBG sensor did after 120-s irradiation (i.e., 98.7 ° C ± 6.1 ° C for FBG versus 131.0 ° C ± 5.1 ° C for thermocouple; p < 0.001 ). Ex vivo porcine urethra tests confirmed the real-time temperature measurements of the FBG sensor as well as consistently circumferential tissue denaturation after 72-s irradiation ( coagulation thickness = 2.2 ± 0.3 ?? mm ). The implementation of FBG can be a feasible sensing technique to instantaneously monitor the temperature developments during diffuser-assisted LITT for treatment of tubular tissue structure.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Real-time temperature monitoring with fiber Bragg grating sensor during diffuser-assisted laser-induced interstitial thermotherapy

et al. 2017

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“…DVIU is a safe, minimally invasive, easy and time effective treatment for initial management of short segment urethral strictures [8], [9] and also has the advantage of a short convalescence period [9]. The position for transurethral management of urethral stricture is usually dorsal lithotomy position with the buttocks of the patient moved to the edge of the bed [10].…”

Section: Literature Review and Case Discussionmentioning

confidence: 99%

Direct Visual Internal Urethrotomy in Supine Position in a Patient with Complex Deformities of Both Lower Limbs and Neurogenic Bladder: A Case Report

Eze

Chacha

Mbaeri

2021

EJMED

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Direct visual internal urethrotomy (DVIU) is a minimally invasive treatment for urethral stricture and is usually done in lithotomy position. We presented a case of a 35-year-old man with complex deformities of both lower limbs from birth. The lower limbs were severely wasted with ankylosis of the hips, flexion of the knee joints and dorsiflexion at the ankle joints. He had a history of progressively worsening difficult in urination characterized by frequency, urgency, urgency incontinence, nocturia, poor urinary stream (improved by straining), intermittency and feeling of incomplete bladder emptying. He had occasional dysuria and total hematuria. He was not a known hypertensive or diabetic patient. No history of trauma, previous urethral instrumentation, and no history of purulent urethral discharge before the onset of problems. On presentation, his abdomen was full with slight suprapubic distention. The anal sphincter was spastic and the prostate was not enlarged. He had normal non-circumcised male external genitalia. There was no spinal deformity and the upper limbs were normal. White cell count was 14,000 cells/ mm3 with a differential neutrophil of 85.5% and urine culture showed moderate growth of coliforms. Abdominopelvic ultrasound showed a thickened bladder wall with mild hydronephrosis bilaterally and a retrograde urethrography and micturating cystourethrography showed 3 short segment bulbar urethral strictures. There was also a Christmas tree appearance of the bladder. A diagnosis of bladder outlet obstruction secondary to multiple short segment idiopathic bulbar urethral strictures on background neurogenic bladder was made. He had intravenous antibiotics for 48 hours and subsequently a DVIU under spinal anesthesia and in the supine position. Catheter was removed on the 7th day post procedure and he started clean intermittent catheterization (CIC) with 12 French catheters. Seven months post procedure, patient is still satisfied with the outcome of his treatment. We concluded that DVIU can be done safely in the supine position and CIC can help improve post procedure outcome and in managing comorbid neurogenic bladder.

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“…The main advantages include the ability to perform it as a daycare procedure, less pain, early recovery, and short duration of hospital stay. Another appealing advantage is that it can be performed even in surgically unfit patients under local anesthesia in minimal resource settings [5].…”

Section: Discussionmentioning

confidence: 99%

A Novel Method of Local Anesthesia for Optical Internal Urethrotomy

Darlington

2019

Cureus

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Direct vision internal urethrotomy (DVIU) is the treatment of choice for short anterior urethral strictures. It is performed under spinal or general anesthesia although it can also be done under local anesthesia. We describe a novel method of local anesthesia for internal urethrotomy. The technique described is feasible in morbid patients who are deemed unfit for spinal or general anesthesia and achieves good analgesia.

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Opinion: Endoscopic Urethrotomy

Cited by 8 publications

References 19 publications

Real-time temperature monitoring with fiber Bragg grating sensor during diffuser-assisted laser-induced interstitial thermotherapy

Real-time temperature monitoring with fiber Bragg grating sensor during diffuser-assisted laser-induced interstitial thermotherapy

Direct Visual Internal Urethrotomy in Supine Position in a Patient with Complex Deformities of Both Lower Limbs and Neurogenic Bladder: A Case Report

A Novel Method of Local Anesthesia for Optical Internal Urethrotomy

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