Internal urethrotomy and intraurethral submucosal injection of triamcinolone in short bulbar urethral strictures

Mazdak, Hamid; Izadpanahi, Mohammad Hossein; Ghalamkari, Asghar; Kabiri, Majid; Khorrami, Mohammad-Hatef; Nouri-Mahdavi, Kia; Alizadeh, Farshid; Zargham, Mahtab; Tadayyon, Farhad; Mohammadi, Ahmad; Yazdani, Mehrdad

doi:10.1007/s11255-009-9663-5

Cited by 75 publications

(52 citation statements)

References 12 publications

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“…Steroids, with the most described agent triamcinolone (40 mg) (45), work by enhancing collagenase activity, act to break down peptide bonds in collagen to allow tissue remodeling. Eltahawy et al evaluated 24 patients with recurrent or resistant bladder neck stenoses post-RRP who underwent Holmium laser BNI with injection of triamcinolone, with a success rate of 83% at 24 months (46).…”

Section: Managementmentioning

confidence: 99%

Management of bladder neck stenosis and urethral stricture and stenosis following treatment for prostate cancer

Nicholson

Al-Hakeem

Maldonado

et al. 2017

Transl. Androl. Urol.

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The aim of this review is to examine all urethral strictures and stenoses subsequent to treatment for prostate cancer, including radical prostatectomy (RP), radiotherapy, high intensity focused ultrasound (HIFU) and cryotherapy. The overall majority respond to endoscopic treatment, including dilatation, direct visual internal urethrotomy (DVIU) or bladder neck incision (BNI). There are adjunct treatments to endoscopic management, including injections of corticosteroids and mitomycin C (MMC) and urethral stents, which remain controversial and are not currently mainstay of treatment. Recalcitrant strictures are most commonly managed with urethroplasty, while recalcitrant stenosis is relatively rare yet almost always associated with bothersome urinary incontinence, requiring bladder neck reconstruction and subsequent artificial urinary sphincter (AUS) implantation, or urinary diversion for the devastated outlet.

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Section: Managementmentioning

confidence: 99%

Management of bladder neck stenosis and urethral stricture and stenosis following treatment for prostate cancer

Nicholson

Al-Hakeem

Maldonado

et al. 2017

Transl. Androl. Urol.

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“…40,41 Studies evaluating the use of triamcinolone injection have shown a significant decrease in both time to recurrence and recurrence rate at 12 months without any significant increase in rates of perioperative complications. 42,43 …”

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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“…According to recent studies, the efficacy of agents such as mitomycin C and triamcinolone injected into the scar tissue has been studied to decrease recurrence rates at the time of internal urethrotomy (57,58,59,60,61).…”

Section: Internal Urethrotomymentioning

confidence: 99%

Urethral Stricture is an Unpleasant Complication after Prostate Surgery: A Critical Review of Current Literature

Söğütdelen¹,

Haberal²,

Guliyev³

et al. 2016

jus

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Prostatectomy is one of the main causes of surgery in aging male population. Besides traditional techniques, novel minimally invasive approaches may also end up with certain complications following prostate surgery. Transurethral procedures may cause iatrogenic urethral trauma. Factors that may influence the development of iatrogenic endoscopic urethral strictures include "electrical dispersion" generated by unipolar current and the "diameter of the instruments" used. Those complications not only bother quality of life of the patients but also may cause various adjunctive procedures with an economical impact.Urethral stricture is the abnormal narrowing of any segment of the urethra surrounded by corpus spongiosum. It specifically means varying degrees of spongiofibrosis that refers to scarring of the corpus spongiosum (1). Any inflammation of the urethra can result in scarring that can lead to a stricture or a narrowing of the urethra. Besides prostate surgery, trauma, infections, tumors or any other cause of scarring may trigger urethral stricture (2). A recent metaanalysis including 732 patients showed that idiopathic and iatrogenic etiologies were by far the most common, accounting for 33% and 33% of all cases, respectively. Inflammatory and posttraumatic etiologies were found in only 15% and 19% of patients, respectively (3).Here, we tried to review the incidence and the basic risk factors that cause urethral stricture following prostate surgery. ÖZÜretral striktür enflamasyona bağlı olarak skarlaşma sonrası üretradaki daralmadır. Elli yaş üzeri erkeklerde benign ve malign hastalıklara bağlı olarak yapılan prostatektomiler oldukça yaygın olarak uygulanmaktadır. Prostatın transüretral rezeksiyonu sonrası farklı serilerde %19'a kadar çıkan oranlarda üretral darlık ve mesane boynu kontraksiyonu görülmektedir. Lazer prostatektomi sonrası üretral darlık prostatın transüretral rezeksiyonuna oranla daha az olarak görülmektedir, yaklaşık olarak %3,6 oranındadır. Açık prostatektomi en eski yöntem olmasına rağmen büyük prostat boyutlu hastalarda oldukça mantıklı bir alternatiftir. Açık prostatektomi sonrası yaklaşık olarak %1,9-4,8 oranında darlık bildirilmiştir. Radikal prostatektomi (RP) lokalize prostat kanseri tedavisinde bütün dünyada en yaygın olarak uygulanan yöntemdir. RP sonrası anastomoz seviyesinde mesane boynu kontraksiyonu olması iyi bilinen bir komplikasyondur ve yaklaşık olarak hastaların %0,4-32'sinde görülmektedir. Darlık büyük oranda endoskopik yöntemlerle tedavi edilmektedir, nadiren komplike olgularda bukkal mukoza greftli üretroplasti gerekebilmektedir. Anahtar Kelimeler: Üretral darlık, prostat cerrahisi, transüretral rezeksiyon, açık prostatektomi, radikal prostatektomi ABSTRACTUrethral stricture is narrowing of the urethra due to inflammation that results in scarring. Prostatectomies for benign and malign prostatic diseases are common surgical procedures among men mainly after their fifties. Urethral stricture or bladder neck contraction following transurethral resection of the prostate (TURP)...

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Internal urethrotomy and intraurethral submucosal injection of triamcinolone in short bulbar urethral strictures

Abstract: Injection of triamcinolone significantly reduced stricture recurrence after internal urethrotomy. Further investigations are warranted to confirm its efficacy and safety.

Cited by 75 publications

References 12 publications

Management of bladder neck stenosis and urethral stricture and stenosis following treatment for prostate cancer

Management of bladder neck stenosis and urethral stricture and stenosis following treatment for prostate cancer

Male urethral strictures and their management

Urethral Stricture is an Unpleasant Complication after Prostate Surgery: A Critical Review of Current Literature

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