Anterior Urethroplasty for the Management of Urethral Strictures in Males: A Systematic Review

Jasionowska, Sara; Bochinski, Antoni; Shiatis, Vishal; Singh, S.K.; Rees, Rowland; Ahmed, Kamran

doi:10.1016/j.urology.2021.09.003

Cited by 4 publications

(2 citation statements)

References 59 publications

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“…Поскольку в настоящее время используются разные варианты расширяющей уретропластики (операции Barbagli, Kulkarni, Asopa, Palminiery, вентральная уретропластика, двухэтапная операция Brakka), то в литературе обсуждаются вопросы эффективности этих вариантов операций, профилактики и диагностики развития осложнений в сравнительном аспекте. При этом некоторые авторы сообщают об определенных различиях [14,15]. Также актуален вопрос об осложнениях и эффективности этих операций при повторной уретропластике после неудачных первичных операций, и хотя в целом ряд авторов не находят существенных различий [16][17][18], но по отдельным вариантам операций и в зависимости от локализации стриктуры они выявляются [13,19,20].…”

Section: Introductionunclassified

Analysis of results and complications after plastic surgery of recurrent urethral strictures.

I.A.,

N.V.,

A.V.

et al. 2024

ECU

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Introduction. Over the past 30 years in reconstructive urology there has been a tendency to reduce the frequency of use of minimally invasive methods of surgical treatment of urethral strictures of various localizations and the predominant use of reconstructive plastic interventions with the expansion of the narrowed area of the urethra using inserts from various tissues. Buccal dilation urethroplasty is currently recognized as the optimal treatment option for urethral strictures of various locations and of varying length. Thus, the issue of choosing the most appropriate method of surgical intervention for recurrent urethral strictures, in the context of a possible increase in the risk of complications, requires additional research. Purpose. To analyze and evaluate the results and complications after plastic surgery of recurrent urethral strictures using a free autograft of the buccal mucosa. Materials and methods. The analysis included data on 51 patients operated on at the Research Institute of Urology and Interventional Radiology named after. N.A. Lopatkina–branch of the Federal State Budgetary Institution National Medical Research Center of Radiology of the Ministry of Health of the Russian Federation for the period from 2014 to 2021 regarding recurrent urethral stricture. The average age of the patients was 36.2±1.6 years (from 18 to 58 years). The diagnosis of recurrent urethral stricture was confirmed by anamnesis, clinical and laboratory examination according to a standard protocol, and special examination methods (uroflowmetry, ultrasound examination of the bladder, retrograde or antegrade cystourethrography, voiding urethrography). According to indications, fibrourethrocystoscopy was performed. According to radiological research methods, the localization and extent of urethral stricture were determined. The functional state of the bladder and the severity of bladder outlet obstruction were determined by the volume of residual urine determined by ultrasound of the bladder, as well as by uroflowmetry data. Results. An analysis of the results and complications after plastic surgery of recurrent urethral strictures using a buccal flap was carried out after repeated operations. As the length of the stricture increases, the risk of its recurrence increases significantly. The most significant factors are the location of the stricture in the penile region and its extent. No other long-term complications (newly developed urinary incontinence/erectile dysfunction) were observed in any case in the analyzed group of patients. Conclusion. Repeated operations for recurrent urethral strictures can eliminate urinary disorders with an effectiveness close to (or equal to) that of primary operations. When choosing a method of surgical treatment of recurrent strictures, both the extent of the stricture and its location should be taken into account. The presence of an extended stricture of the penile urethra may be a risk factor for its recurrence. Complications that develop after repeated operations in the vast majority of cases are not life-threatening. The question of the effectiveness of different types of surgery requires additional research with the accumulation of clinical material.

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Section: Introductionunclassified

Analysis of results and complications after plastic surgery of recurrent urethral strictures.

I.A.,

N.V.,

A.V.

et al. 2024

ECU

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“…Later from the end of the 90s and beginning of the 2000s urethral stricture reconstruction surgery began to be performed more often [ 7–11 ]. Due to advantages like the ability to easily obtain buccal mucosa, lack of hair follicles, having lamina propria rich in fine veins, easy inosculation and imbibition into the urethral bed, and adaptation to the wet environment, buccal mucosa is a successful graft source in the long term for urethral stricture [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

Comparison of closure versus non-closure of the intraoral buccal mucosa graft site in urethroplasties. A systematic review and meta-analysis

Güler¹

2022

Arab Journal of Urology

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Aim To assess postoperative oral morbidity through meta-analysis of comparative studies for closure or non-closure of the buccal mucosa graft harvest area in patients undergoing urethroplasty. Methods A systematic literature review was conducted in January 2022. Randomized controlled studies were assessed according to the Cochrane collaboration guidelines. Postoperative pain, difficult mouth opening, alteration of oral salivation, perioral numbness, and tolerance of solid and liquid intake results were assessed. Standard mean differences and risk ratios with 95% confidence intervals were estimated for relative risk. Assessment was performed with subgroup analyses according to time points. Results This meta-analysis included 373 patients in 7 randomized studies. The oral pain overall pooled effect estimates were investigated for the time points of day 0–1, day 3–7 and months 1–6. According to corrected effect estimates after sensitivity analysis, at the day 0–1 time point, the non-closure group was significantly superior compared to the closure group. But there was no difference at the other time points and in total. The overall pooled effect estimates for difficult mouth opening were investigated at 4 time points (day 1, days 5–7, months 1–3 and months 6). After sensitivity analysis, the overall pooled effect estimates at 6 months were significantly superior for the non-closure group. There were no significant differences between the non-closed and closed groups based on the overall pooled-effect estimates for oral numbness, salivary secretion alteration, and tolerance of liquid and solid food variants. Conclusion The non-closure group was more advantageous in terms of oral pain in the early postoperative period. There were no differences between the groups in terms of alteration of salivation, oral numbness and toleration of liquid/solid food. Although the non-closed group seems more advantageous in terms of ease in mouth movements, more studies are needed to prove this.

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Oral Health and Oral Mucosa as A Graft Material for Urinary System: A Narrative Review

Akyol,

Ergün

et al. 2024

Curr Oral Health Rep

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Anterior Urethroplasty for the Management of Urethral Strictures in Males: A Systematic Review

Cited by 4 publications

References 59 publications

Analysis of results and complications after plastic surgery of recurrent urethral strictures.

Analysis of results and complications after plastic surgery of recurrent urethral strictures.

Comparison of closure versus non-closure of the intraoral buccal mucosa graft site in urethroplasties. A systematic review and meta-analysis

Oral Health and Oral Mucosa as A Graft Material for Urinary System: A Narrative Review

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