Erectile impotence as complication of direct vision cold knife urethrotomy

McDermott, David W.; Bates, Robert J.; Heney, Niall M.; Althausen, Alex F.

doi:10.1016/0090-4295(81)90291-0

Cited by 23 publications

(9 citation statements)

References 5 publications

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“…Internal urethrotomy can have complications such as urethral hemorrhage, perineal hemorrhage and extravasation of irrigation into perispongiosal tissues, scrotal oedema, creation of a false passage, rectal perforation, epididymo-orchitis, meatal stenosis, incontinence, fever, bacteremia, urinary sepsis, and scrotal abscess. With deep incisions at the 10 o'clock and 2 o'clock positions, there is also a risk of entering the corpus cavernous and creating fistulas between corpus spongiosum and cavernous, leading to erectile dysfunction [28] , [29] , [30] , [31] . Overall, however, the incidence of these complications is around 2%–10% but in addition there can be recurrence of the urethral strictures.…”

Section: Managementmentioning

confidence: 99%

Overcoming scarring in the urethra: Challenges for tissue engineering

Şimşek

Aldamanhori

Chapple

et al. 2018

Asian Journal of Urology

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Urethral stricture disease is increasingly common occurring in about 1% of males over the age of 55. The stricture tissue is rich in myofibroblasts and multi-nucleated giant cells which are thought to be related to stricture formation and collagen synthesis. An increase in collagen is associated with the loss of the normal vasculature of the normal urethra. The actual incidence differs based on worldwide populations, geography, and income. The stricture aetiology, location, length and patient's age and comorbidity are important in deciding the course of treatment. In this review we aim to summarise the existing knowledge of the aetiology of urethral strictures, review current treatment regimens, and present the challenges of using tissue-engineered buccal mucosa (TEBM) to repair scarring of the urethra. In asking this question we are also mindful that recurrent fibrosis occurs in other tissues—how can we learn from these other pathologies?

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Section: Managementmentioning

confidence: 99%

Overcoming scarring in the urethra: Challenges for tissue engineering

Şimşek

Aldamanhori

Chapple

et al. 2018

Asian Journal of Urology

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“…37 Of note, erectile dysfunction is particularly common in patients with long and dense strictures requiring extensive incision. 38,39 In general, complications associated with internal urethrotomy are more likely to occur in men with a positive urine culture, a history of urethral trauma, multiple stricture segments, and long (>2 cm) strictures. 13 …”

Section: Managementmentioning

confidence: 99%

Male urethral strictures and their management

2013

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Male urethral stricture disease is prevalent and has a substantial impact on quality of life and health-care costs. Management of urethral strictures is complex and depends on the characteristics of the stricture. Data show that there is no difference between urethral dilation and internal urethrotomy in terms of long-term outcomes; success rates range widely from 8–80%, with long-term success rates of 20–30%. For both of these procedures, the risk of recurrence is greater for men with longer strictures, penile urethral strictures, multiple strictures, presence of infection, or history of prior procedures. Analysis has shown that repeated use of urethrotomy is not clinically effective or cost-effective in these patients. Long-term success rates are higher for surgical reconstruction with urethroplasty, with most studies showing success rates of 85–90%. Many techniques have been utilized for urethroplasty, depending on the location, length, and character of the stricture. Successful management of urethral strictures requires detailed knowledge of anatomy, pathophysiology, proper patient selection, and reconstructive techniques.

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“…The incidence of iatrogenic impotence from various procedures has been reported as follows: radical prostatectomy, 43% to 100%; perineal prostatectomy for benign disease, 29%; abdominal perineal resection, 15% to 100%; and external sphincterotomy at the 3-and 9-o'clock positions, 2% to 49%. [51][52][53][54][55][56] An improved understanding of the neuroanatomy of the pelvic and cavernous nerves has resulted in modified surgery for cancer of the rectum, bladder, and prostate, producing a lower incidence of iatrogenic impotence. 53 For example, the introduction of nerve-sparing radical prostatectomy has reduced the incidence of impotence from nearly 100% to 30-50%.…”

Section: Neurogenicmentioning

confidence: 99%

Physiology of Penile Erection and Pathophysiology of Erectile Dysfunction

Dean

Lue

2005

Urologic Clinics of North America

482

308

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This article reviews the physiology of penile erection, the components of erectile function, and the pathophysiology of erectile dysfunction. The molecular and clinical under-standing of erectile function continues to gain ground at a particularly fast rate. Advances in gene discovery have aided greatly in working knowledge of smooth muscle relaxation/contraction pathways. The understanding of the nitric oxide pathway has aided not only in the molecular understanding of the tumescence but also greatly in the therapy of erectile dysfunction.

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Erectile impotence as complication of direct vision cold knife urethrotomy

Cited by 23 publications

References 5 publications

Overcoming scarring in the urethra: Challenges for tissue engineering

Overcoming scarring in the urethra: Challenges for tissue engineering

Male urethral strictures and their management

Physiology of Penile Erection and Pathophysiology of Erectile Dysfunction

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