High-pressure balloon dilation for male anterior urethral stricture: single-center experience

Abstract

Abstract:Objectives: We retrospectively reviewed the urethral stricture cases treated in our tertiary center, and assessed the safety and feasibility of the high-pressure balloon dilation (HPBD) technique for anterior urethral stricture. Methods: From January 2009 to December 2012, a total of 31 patients with anterior urethral strictures underwent HPBD at our center, while another 25 cases were treated by direct vision internal urethrotomy (DVIU). Patient demographics, stricture characteristics, surgical techniques, and operative outcomes were assessed and compared between the two groups. The Kaplan-Meier survival analysis was applied to evaluate the stricture-free rate for the two surgical techniques. Results: The operation time was much shorter for the HPBD procedure than for the DVIU ((13.19±2.68) min vs. (18.44±3.29) min, P<0.01). For the HPBD group, the major postoperative complications as urethral bleeding and urinary tract infection (UTI) were less frequently encountered than those in DVIU (urethral bleeding: 2/31 vs. 8/25, P=0.017; UTI: 1/31 vs. 6/25 P=0.037). The Kaplan-Meier survival analysis showed that there was no significant difference in stricture-free rate at 36 months between the two groups (P=0.21, hazard ratio (HR)=0.65, 95% confidence interval (CI): 0.34 to 1.26). However, there was a significantly higher stricture-free survival in the HPBD group at 12 months (P=0.02, HR=0.35, 95% CI: 0.14 to 0.87), which indicated that the stricture recurrence could be delayed by using the HPBD technique. Conclusions: HPBD was effective and safe and it could be considered as an alternative treatment modality for anterior urethral stricture disease.

Long-Term Experience with Balloon Dilation for Short Bulbar and Membranous Urethral Strictures: Establishing a Baseline in the Active Drug Treatment Era

“…The low complication rate is likely related to the mechanism of BD, which applies radial force to strictures under direct vision and is generally less traumatic with a lower bleeding risk and infection rate compared to blind sequential dilation or DVIU [ 10 ]. One study directly comparing BD to DVIU revealed shorter operative times and lower complication rates with BD [ 11 ].…”

Risk factors and drug resistance in early-onset neonatal group B streptococcal disease

“…Notably, our logistic regression analysis revealed three factors that were associated with variations in GBS: premature rupture of membranes was identified as a risk factor, and the other two factors were found to be protective factors. Perhaps the bacteria involved in gravida urinary tract infections have a competitive relationship with GBS and other bacteria (Yu et al, 2016). To our knowledge, the low GBS infection rate of premature neonates has not been previously reported.…”

Optilume drug‐coated balloon for anterior urethral stricture: 2‐year results of the ROBUST III trial

“…Methods for mechanical disruption of urethral stricture include balloon dilation, DVIU and sequential dilation using urethral sounds 20,21 . Although some surgeons prefer DVIU given the ability to directly visualize the stricture at time of dilation, both balloon dilation and rigid dilators have been shown to outperform DVIU with respect to long‐term retreatment rate 21–23 . Concerns regarding poor placement of the balloon during dilation may be obviated either by performing balloon dilation under direct vision or by using intra‐operative fluoroscopy for stricture localization 21,24,25 .…”