Male urethral strictures and their management

Hampson, Lindsay A.; McAninch, Jack W.; Breyer, Benjamin N.

doi:10.1038/nrurol.2013.275

Cited by 172 publications

(171 citation statements)

References 119 publications

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“…In fact, urethroplasty is the most effective method for definitive correction of urethral strictures and this is generally considered to be the gold-standard treatment (61,65,66). Risk factors associated with failure include incomplete excision of scar tissue, anastomotic tension and the presence of lichen sclerosis (67).…”

Section: Urethroplastymentioning

confidence: 99%

See 1 more Smart Citation

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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Section: Urethroplastymentioning

confidence: 99%

“…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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“…Recent informations suggest that all five recipients report the transplants are functioning well. 13 In as much as urethral stricture is a highly disabling condition and is not so uncommon in our places, it definitely plays an important role in a sufferer's daily life. Unless we come to know the actual problems related to these sufferers it would be unwise to think of measures to be taken to solve the problems of these patients.…”

Section: Emergency Treatmentmentioning

confidence: 99%

A qualitative study on the perceptions of patients with urethral stricture

et al. 2017

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Background: Urethral stricture means narrowing of the urethra and is caused due to injury, instrumentation, infection etc. In as much as urethral stricture is a highly disabling condition and is common in our places, it definitely plays an important role in a sufferer daily life. In our project, we have ventured a qualitative study of perceptions and actual impositions on the life of patients suffering from chronic urethral stricture.Methods: The study was one of qualitative descriptive type involving in depth interviews (IDI) of 18 male patients of Urethral stricture who were diagnosed and treated at IPGMER.Results: The results showed that the IDIs could be divided into several categories each of which is further divided into several codes. The categories are given here with codes in parenthesis. Catheter related problems (leakage, block, physical problems, change, availability, health personnel, dress change, smell of urine, water drinking), disturbance of sleep (initiation, awakening, disturbance of bed partner, sleepless night), Role of family members (care giving, attitude, negligence), financial condition (jobless, help from friends, support, reversal of role, family crisis), social life (activity, enjoyment, getting hurt), mental health (loneliness, helplessness, sadness, getting hope) and sexual life (urge, erection, coital pain , discomfort).Conclusions: The major findings were that most of the patients had very good co-operation and care from the family; financial assistance was also obtained from family and friends. Majority of the patients were hopeful that they would be totally cured in near future.

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“…16 Two of the mainstays of surgical treatment include incision of the urethral stricture with direct vision internal urethrotomy or urethral reconstruction with urethroplasty. 17 Differences in these treatment options include the extent of the procedure, the duration of the postoperative catheterization, recovery time, and overall success rate. Understanding and weighing these treatment options with varied risks and benefits can be understandably difficult for patients, particularly when the disease process and treatment options may impact quality of life.…”

mentioning

confidence: 99%

Patient-centered Treatment Decisions for Urethral Stricture: Conjoint Analysis Improves Surgical Decision-making

Hampson¹,

Allen

Gaither³

et al. 2017

Urology

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OBJECTIVE To determine whether the use of a choice-based conjoint analysis (CA) exercise decreased patients’ decisional conflict about treatment preferences for surgical management of urethral stricture disease. Understanding patient preferences for treatment decisions assists in shared decision-making and emphasizes patient-centered outcomes. CA offers a method to understand what risks patients are willing to take for what gains. METHODS The CA methodology was used by providing participants with case-based choices to elucidate the relative importance that individuals place on various treatment aspects. Patients’ decisional conflict regarding surgery for urethral stricture was assessed before and after the CA exercise to assess the impact the exercise had on their decisional conflict. RESULTS Completion of the CA exercise resulted in a significant decrease in decisional conflict (P < .001). The majority (59.5%) of participants with decisional conflict before the CA exercise experienced a decrease in decisional conflict afterwards, with only a minority (16.5%) experiencing new decisional conflict after the exercise. Participants felt the choice-based CA exercise was helpful in deciding what was important in making treatment decisions (70%) and in expressing their priorities and treatment preferences (82%). The number needed to counsel to achieve a decrease in decisional conflict was 1.69 and to achieve no decisional conflict was 3.65. CONCLUSION Choice-based CA improves patients’ ability to express their treatment preferences and decreases decisional conflict. CA may be a new tool that physicians and patients can use to aid in shared decision-making with a focus on patient-centered outcomes.

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Male urethral strictures and their management

Cited by 172 publications

References 119 publications

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

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

A qualitative study on the perceptions of patients with urethral stricture

Patient-centered Treatment Decisions for Urethral Stricture: Conjoint Analysis Improves Surgical Decision-making

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