Surgical Treatment and Prevention of Recurrence of Urethral Calculi Associated with Hairballs after Urethroplasty

Abstract

Objectives: To evaluate technical aspects and outcome of preventing urethrocutaneous fistula and calculi recurrence in surgical treatment of urethral calculi associated with hairballs after urethroplasty. Patients and Methods: Sixteen patients who had urethral calculi associated with hairballs after urethroplasty underwent urethrolithotomy and trimming and epilation of the neourethra. While operating, we made a staggered incision of the skin and urethra, carefully su-tured the urethral incision, and covered it by well-vascularized tissue. A tube-in-tube stent method was performed on the latter 12 patients for better drainage of the exudates that accumulated in the urethra. Results: All calculi were successfully removed. Surgical site infection occurred in the last one of the former 4 patients and resulted in an urethrocutaneous fistula. There were no other complications. All patients were followed up for 2-7 years; no urethral stenosis or recurrence of calculi was observed, and remarkable reduction of urethral hair was obtained. Conclusions: Urethrolithotomy and trimming and epilation of the neourethra seem to be appropriate treatments for urethral calculi associated with hairballs after urethroplasty. Full attention should be paid to fistula prevention.

Acellular Bi-Layer Silk Fibroin Scaffolds Support Tissue Regeneration in a Rabbit Model of Onlay Urethroplasty

“…In circumstances in which there is a lack of patient urethral tissue, extragenital skin flaps [9] , [10] , buccal mucosa [11] , bladder mucosa [12] , [13] , and tunica vaginalis [14] have been utilized clinically as autologous tissue grafts for urethroplasty procedures. In addition to the risk of donor site morbidity, the long-term success of these implants is often suboptimal due to significant complications such as fistula formation [15] , recurrent strictures [16] , hair growth [17] , stone formation [18] , diverticula [19] , and meatal stenosis [20] . Given the limitations associated with conventional surgical approaches, there exists a substantial need for the development of alternative strategies for urethral tissue replacement.…”

Urethral Hair Bezoar Management With Transcutaneous Neodymium-Doped Yttrium Aluminum Garnet Laser Post-hypospadias Repair: A Clinical Case

“…A few cases of hair bezoars forming inside the urethral diverticulum, either alone or in conjunction with stones, have been published. These patients underwent open surgical excision [ 8 , 14 ], transcutaneous [ 11 ], intraurethral laser hair ablation [ 9 , 15 , 16 ], or multiple procedures. Some patients have presented with solitary or multiple stones in the neo-urethra associated with hair growth, which can exacerbate complications [ 8 , 15 , 16 ].…”

“…These patients underwent open surgical excision [ 8 , 14 ], transcutaneous [ 11 ], intraurethral laser hair ablation [ 9 , 15 , 16 ], or multiple procedures. Some patients have presented with solitary or multiple stones in the neo-urethra associated with hair growth, which can exacerbate complications [ 8 , 15 , 16 ]. There may be a causal association between stenosis, diverticula, hair growth, and stone formation.…”

The Rising Obstacles and Hopes Available in Urethral Replacement

“…A latest study comparing biomechanical characteristics and biocompatibility of these natural scaffolds showed favorable properties in all with ACSM performing best, helping its potential use in urethral tissue engineering in future. Newer scaffolds, which includes silk fibroin, with ever growing biocompatibility and less capability for irritation are currently being, evolved [6].…”