Early catheter removal after anterior anastomotic (3 days) and ventral buccal mucosal onlay (7 days) urethroplasty

Al-Qudah, Hosam S.; Cavalcanti, André G.; Santucci, Richard A.

doi:10.1590/s1677-55382005000500007

Cited by 28 publications

(17 citation statements)

References 18 publications

(4 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Period of postoperative catheterization after excision and primary anastomosis varies in literature from 3-21 days with a success rate of 90-98%. [1][2][3][4][5][6][7][8][9] However, only a few authors have reported their extravasation rates before removal of catheter (Table 2). Some authors prefer voiding cystourethrogram (VCUG) to see extravasation but we routinely perform PUG as it avoids unnecessary urethral manipulations such as removing and then reinserting the catheter.…”

Section: Discussionmentioning

confidence: 99%

“…Santucci et al reported that out of 168 patients undergoing anastomotic urethroplasty for bulbar urethral stricture, only 1% had extravasation following catheter removal on day 14 with 95% success rate. [2] Al-Qudah et al [4] reported 17% (n=2/12) extravasation rate on VCUG done on postoperative day 3 after anastomotic urethroplasty; as compared to absence of extravasation (n=0/7) in whom VCUG was done 8 days after surgery. The recurrence rate of stricture was comparable between 2 groups i.e 8% (n=1/12) in the early group vs 14% (n=1/7) in the late group.…”

Section: Discussionmentioning

confidence: 99%

“…The time for removal of the urethral catheter after excision and primary anastomosis (EPA) performed for anterior urethral stricture disease varies in literature from 3 to 21 days. [1][2][3][4][5][6][7][8][9] However, there is disparity regarding the earliest feasible time of catheter removal after EPA and this decision usually depends upon surgeon's opinion. Early removal of the urethral catheter has been studied in radical retropubic prostatectomy and has proved to improve patient mobility and comfort.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Early removal of urinary catheter after excision and primary anastomosis in anterior urethral stricture

Bansal¹,

Sankhwar²,

Gupta³

et al. 2016

Turkish Journal of Urology

View full text Add to dashboard Cite

Objective: To investigate the feasibility of removing the urinary catheter 7 days after excision and primary anastomosis (EPA) performed with the indication of anterior urethral stricture disease. Material and methods:Retrospective review of medical records of the patients who had undergone EPA between January 2005 and December 2010 was performed. These patients were divided into 2 groups: Group 1 (urethral catheter removed on or before 7. postoperative day) and Group 2 (urethral catheter removed on 8. postoperative day or later). We compared 2 groups as for the frequency of extravasation as detected on retrograde pericatheter urethrogram (PUG) and recurrence rate till the last follow-up.Results: PUG was performed on an average day 7 and 14 in Groups 1 (n=102) and 2 (n=134), respectively followed by removal of the catheter. Extravasation on the first PUG was detected in 6.8% of the patients in Group 1, and in 4.5% of the cases in Group 2 had extravasation on the first PUG. Urethral catheter was left in situ in these patients and a repeat PUG after one week was performed which was normal in all cases. The incidence of extravasation and recurrence rate did not differ significantly whether catheter was removed on day 7 or 14 (6.8% vs. 4.5% and 4.9% vs. 5.2% respectively) (p>0.5). Conclusion:We conclude that removal of the catheter on postoperative day 7 after EPA does not increase the rate of extravasation and recurrence during long-term follow-up. Urethral catheter restricts physical activity in the postoperative period which is bothersome to the patient. Hence early removal of a catheter should be offered to men after EPA.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Early removal of urinary catheter after excision and primary anastomosis in anterior urethral stricture

Bansal¹,

Sankhwar²,

Gupta³

et al. 2016

Turkish Journal of Urology

View full text Add to dashboard Cite

show abstract

“…[345] Still there is some controversy existing about the best feasible time of proper healing and how to assess it by simple procedures. [6] There is a difference in the duration of anastomotic healing according to the type of procedure performed, but whether there is any significant difference in duration of healing at the anastomotic site according to etiology of short-segment stricture urethra is still a dilemma. [7] Pericatheter retrograde urethrogram (PUG) is well described but not accepted widely.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of healing at urethral anastomotic site by pericatheter retrograde urethrogram in patients with urethral stricture

et al. 2014

View full text Add to dashboard Cite

Introduction:Stricture urethra has been always a surgical challenge. Different opinions regarding time require healing at anastomotic site after urethroplasty, so various strategies are there regarding time for post-operative catheter removal. In this study, healing was assessed by pericatheter retrograde urethrogram (PUG) before the catheter removal.Materials and Methods:Prospective study was conducted from January 2006 to December 2009. Twenty eight cases of short-segment urethral stricture (<2 cm) who underwent urethroplasty were included and divided into two groups depending upon etiology; post-traumatic group (road traffic accident/straddle type injury) and iatrogenic stricture group (due to prolong catheterization/after cystoscopy/Faulty Foleys balloon placement). Post-operative PUG was done on 14th post-operative day in all patients for healing assessment. Extravasation of dye on PUG was taken as anastomotic leak. If the patient had not showed extravasation, the catheter was removed. Otherwise it was kept further for next one week and again PUG was done for healing assessment.Results:Extravasation of dye was noted in 4 patients (33%) of iatrogenic group and 14 patients (87.5%) of the post-traumatic group on 14th post-operative day PUG. (P ≤ 0.05). The decision to remove catheter was depended upon PUG finding and it was safe, no complication was developed in any patient.Conclusion:Iatrogenic strictures have better healing than post-traumatic stricture in the post-operative period. PUG is a safe and simple procedure and can guide about safe removal of catheter in the post-operative period.

show abstract

“…Because it has other advantages (ie, ease of general application, minimal invasiveness, and lower initial procedure cost), it would stand to reason that a slightly lower success rate could be tolerated when compared with urethroplasty; however, the application of urethrotomy should not compromise future salvage of urethrotomy failures with urethroplasty. As urethroplasty transitions to an outpatient procedure (with minimal catheterization time in some centers), must we re-evaluate the relative "invasiveness" of urethroplasty and urethrotomy [3,4]? In this commentary we review the most prominent and relevant endoscopic urethrotomy case series, critique the results and methods, and recommend new directions in developing understanding of this disease and its surgical treatment.…”

mentioning

confidence: 99%

The current role of urethrotomy in anterior urethral stricture disease

Elliott

McAninch²

2006

Curr Urol Rep

View full text Add to dashboard Cite

Urethroplasty is a technique learned by few trainees during their residency. Although some may be comfortable with performing an anastomotic urethroplasty, it is not always possible to preoperatively predict when a more complicated repair may be necessary, and a novice is ill-advised to attempt more complex flap and graft procedures. Alternatives include endoscopic urethrotomy, dilation, and urethral stent. This discussion focuses on the evolving role of internal urethrotomy as an alternative to urethroplasty in the management of anterior urethral stricture disease.In contrast to urethroplasty, endoscopic urethrotomy is easily mastered by most practitioners, is minimally invasive, and can be performed in an outpatient setting. As such, urethrotomy has been embraced by the urology community as a first-line treatment for most urethral strictures. Referral for open reconstruction is usually reserved for the patient who has failed at least one attempt at endoscopic reconstruction, and 38%-75% of patients undergoing reconstruction have failed at least one urethrotomy [1,2].Are the facts that urethrotomy is less invasive than urethroplasty and that urethrotomy can be performed by one's local urologist (rather than requiring a referral to a tertiary care center) sufficient criteria to support the use of urethrotomy as the primary therapy for urethral stricture disease? Furthermore, do some strictures meet the criteria though others do not? If urethrotomy is to be applied (rather than open urethroplasty) because it is less invasive, it should prove to be safer and better tolerated than urethroplasty. Because it has other advantages (ie, ease of general application, minimal invasiveness, and lower initial procedure cost), it would stand to reason that a slightly lower success rate could be tolerated when compared with urethroplasty; however, the application of urethrotomy should not compromise future salvage of urethrotomy failures with urethroplasty. As urethroplasty transitions to an outpatient procedure (with minimal catheterization time in some centers), must we re-evaluate the relative "invasiveness" of urethroplasty and urethrotomy [3,4]? In this commentary we review the most prominent and relevant endoscopic urethrotomy case series, critique the results and methods, and recommend new directions in developing understanding of this disease and its surgical treatment.Endoscopic urethrotomy was initially greeted with exuberance because of its ease of application and excellent reported success rates. Several series reported success rates up to 77% with a follow-up of 9-36 months [5][6][7][8].A critical review of these series shows several flaws. First, the definition of success is variable, with some classifying success based on flow rate, others on patient satisfaction (certainly an inexact measurement when there was no validated questionnaire to assess satisfaction), and others on the need for re-intervention. Second, some series are blind to the number of urethrotomies required to treat the stricture. In fact, some p...

show abstract

Early catheter removal after anterior anastomotic (3 days) and ventral buccal mucosal onlay (7 days) urethroplasty

Cited by 28 publications

References 18 publications

Early removal of urinary catheter after excision and primary anastomosis in anterior urethral stricture

Early removal of urinary catheter after excision and primary anastomosis in anterior urethral stricture

Evaluation of healing at urethral anastomotic site by pericatheter retrograde urethrogram in patients with urethral stricture

The current role of urethrotomy in anterior urethral stricture disease

Contact Info

Product

Resources

About