Etiology of Urethral Stricture Disease in the 21st Century

Lumen, Nicolaas; Hoebeke, Piet; Willemsen, Pieter; Troyer, Bart De; Pieters, Ronny; Oosterlinck, Willem

doi:10.1016/j.juro.2009.05.023

Cited by 353 publications

(287 citation statements)

References 15 publications

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“…89 Patients with strictures most commonly present with a weak stream, with or without lower urinary tract symptoms. A dilatation of the urethra proximal to the stricture can be observed upon physical examination.…”

Section: Urethral Stricturementioning

confidence: 99%

Failed hypospadias in paediatric patients

et al. 2013

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| Failed hypospadias refers to any hypospadias repair that leads to complications or causes patient dissatisfaction. The complication rate after hypospadias repairs ranges from 5-70%, but the actual incidence of failed hypospadias is unknown as complications can become apparent many years after surgery and series with lifelong follow-up data do not exist. Moreover, little is known about uncomplicated repairs that fail in terms of patient satisfaction. Risk factors for complications include factors related to the hypospadias (severity of the condition and characteristics of the urethral plate), the patient (age at surgery, endocrine environment, and wound healing impairment), the surgeon (technique selection and surgeon expertise), and the procedure (technical details and postoperative management). The most important factors for preventing complications are surgeon expertise (number of cases treated per year), interposition of a barrier layer between the urethroplasty and the skin, and postoperative urinary drainage. Major complications associated with failed hypospadias include residual curvature, healing complications (preputial dehiscence, glans dehiscence, fistula formation, and urethral breakdown), urethral obstruction (meatal stenosis, urethral stricture, and functional obstruction), urethral diverticula, hairy urethra, and penile skin deficiency.

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Section: Urethral Stricturementioning

confidence: 99%

Failed hypospadias in paediatric patients

et al. 2013

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“…In Europe, Lumen N et al [5] and Palminteri et al [6] reported higher rates of anterior urethral stricture respectively 60.9% and 77.4%. The stricture of the anterior urethra as well as the urethral stricture in general is a pathology of young adult.…”

Section: Discussionmentioning

confidence: 97%

Male Anterior Urethral Stricture: Epidemiological Profile and Management at Ouagadougou University Teaching Hospital (Burkina-Faso)

Yameogo¹,

Ouattara²,

Kaboré³

et al. 2017

OJU

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It was a retrospective and descriptive study conducted in the urology division of Yalgado Ouedraogo University Teaching Hospital from October 2009 to September 2014. Sixty three (63) male patients with anterior urethral stricture disease were included. All the patients have their diagnosis confirmed by voiding retrograde cystourethrogram (VCUG) or during surgical intervention. Anterior urethral stricture constitutes 41.1% of all urethral stricture. Hospital prevalence was 4.2%. Patient average age was 50.5 years. Dysuria and urinary retention were the major complaints representing respectively 66.7% and 33.3%. The infectious cause of urethral stricture was 71.1% of cases, followed by iatrogenic and traumatic causes with respectively 17.4% and 11.1% of cases. Voiding retrograde urethrocystogram (VCUG) was the only diagnostic procedure. Single urethral stenosis of the anterior urethra was about 88.8% while multiple stenosis constituted about 11.2%. Bulbar urethral stricture was the major location for the stenosis. Urine analysis was performed on 82.5% patients and ruled out urinary infections in 69.2% of cases with identification and isolation of Escherichia Coli in 77.7%. Majority of patients (61.9%) had open surgery of which 39.7% had end to end resection and anastomosis. Dilatation constituted 33.3% of treatment of the stricture of the anterior urethra. No endoscopic treatment was registered. At the removal of the catheter, all were successful but with time, the success rate was 87% at 6 months, 89.7% at 12 months, 85.2% at 18 months 63.1% at 24 months.

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“…7 In the developed world, the aetiology of urethral stricture is mainly iatrogenic, such as transurethral resection, urethral catheterization, cystoscopy, prostatectomy, brachytherapy, hypospadias surgery and idiopathic. 8,9 However in resource poor countries, we still see the pattern of infection and trauma.…”

Section: Discussionmentioning

confidence: 99%

“…12 In the dorsal onlay group two of 40 (5%) men developed restricture after a follow-up of 15 (6-24) months, whereas in the buccal mucosa group four of seven required surgical revision for stricture recurrence at 11 (6)(7)(8)(9)(10)(11)(12)(13)(14) months.…”

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confidence: 99%

A case series of standard surgical management of bulbo-membranous stricture

et al. 2017

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INTRODUCTIONThe urethra is traditionally divided into anterior and posterior parts. The anterior part is surrounded by the corpus spongiosum. It includes the bulbar urethra, which is enclosed by the bulbospongiosus muscle and the penile urethra that runs from the distal margin of the bulbospongiosus to the fossa navicularis and external ABSTRACT Background: Urethral stricture is an acquired permanent narrowing of the urethra impeding the flow of urine during micturition. It is one of the oldest urological diseases, and its treatment remains a challenge for urologists. Urethral stricture disease affects about 300 per 100,000 men. Most common causes are trauma and infections in developing countries and idiopathic in developed countries. Treatment options for short bulbar urethral strictures include dilatation, direct visual internal urethrotomy and anastomotic urethroplasty. Excision and end to end anastomosis (anastomotic urethroplasty) for short bulbo-membranous urethral strictures and buccal mucosal graft gives excellent long term results with reduced recurrence rate. Methods: Sixty-three patients who had undergone anastomotic urethroplasty from 2013 to 2016 at Government Medical College and Superspeciality Hospital, Nagpur, Maharashtra, India Department of Urology were included in the study. For strictures less than 2cm, excision of stricture and anastomosis done, while for stricture more than 2cm buccal mucosal grafting done over 16 F Foleys catheter. Postoperative follow up done up to 1 year. Results: The total number of patients included is 63 and study conducted between January 2013 to December 2016. End to end urethroplasty was done in 41 patients and had mean duration of surgery of about 120 minutes, while buccal mucosal grafting was done in 22 patients. Age ranges from 14 to 78 years with highest incidence of stricture was seen after 5 th decade of life, mainly due to iatrogenic causes of previous instrumentation and post TURP surgery. Strictures in younger adults are mainly as a result of trauma by fall astride injury and pelvic fractures and seen during 3 rd and 4 th decade of life. Most common length of stricture observed was 1-2cm in about 65.07% and mainly occurred due to post urethral procedures. Long strictures more than 2cm were mainly because of trauma in about 35%. Seven patients had recurrence in follow up, out of which 2 managed conservatively by repeated dilatation and 5 patients needed reoperation. Conclusions:The present results suggest that in patients with strictures too long to be excised and re-anastomosed a tension-free buccal mucosal graft provides better results. However, in patients with short strictures, in whom a completely tension-free anastomosis can be achieved, direct end-to-end anastomosis remains good option.

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Etiology of Urethral Stricture Disease in the 21st Century

Cited by 353 publications

References 15 publications

Failed hypospadias in paediatric patients

Failed hypospadias in paediatric patients

Male Anterior Urethral Stricture: Epidemiological Profile and Management at Ouagadougou University Teaching Hospital (Burkina-Faso)

A case series of standard surgical management of bulbo-membranous stricture

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