Newly Diagnosed Bulbar Urethral Strictures: Etiology and Outcome of Various Treatments

Stormont, Thomas J.; Suman, Vera J.; Öesterling, Joseph E.

doi:10.1016/s0022-5347(17)35879-2

Cited by 60 publications

(19 citation statements)

References 15 publications

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“…In stricture treatment, various modalities, such as urethral dilatation, internal urethrotomy, laser, stent application and open surgery are employed 3–5 . Success rates of dilatation, urethrotomy, laser, stent and open surgery have been reported to be 60%, 50%, 56%, 40% and 90%, respectively 5–9 . As open surgery operations require complicated and specialised training, they cannot be carried out at every center.…”

Section: Introductionmentioning

confidence: 99%

“…[3][4][5] Success rates of dilatation, urethrotomy, laser, stent and open surgery have been reported to be 60%, 50%, 56%, 40% and 90%, respectively. [5][6][7][8][9] As open surgery operations require complicated and specialised training, they cannot be carried out at every center. The most commonly used methods are internal urethrotomy and urethral dilatation.…”

Section: Introductionmentioning

confidence: 99%

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Effect of intraurethral Mitomycin‐C on healing and fibrosis in rats with experimentally induced urethral stricture

et al. 2004

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Background : In the pathogenesis of urethral stricture, fibrosis is associated with an excessive collagen increase. After the recognition that topical application of Mitomycin-C (MMC) inhibits fibroblast proliferation and is effective in preventing scar formation, many studies have been carried out on this subject outside the scope of urology. The aim of the present study is to observe the intraurethral impact of the employment of low doses of MMC on scar formation and fibrosis in experimental rat model. Methods : Urethral injuries were made by internal urethrotomy knife. The study was carried out with 35 adult male Wistar albino rats. Five rats were allocated to the control group (group 1), 10 to a group that was administered 2 mg/L MMC (group 2) and 20 to a group that was administered 10 mg/ L MMC (group 3). Mitomycin-C was administered to the injured urethra in the form of irrigation for 5 min. The rats were sacrificed 14 days later in order to evaluate chronic inflammation and fibrosis and their penises were histopathologically examined under light microscopy with hematoxilen eosin and trichrom stains. Results : When group 2 was compared with control group, the differences in hemosiderin-laden macrophages (HLM), mononuclear cell infiltration (MCI) and fibrosis were found to be statistically significant (P < 0.01, P < 0.05, P < 0.005, respectively). When group 3 was compared with control group, the differences in HLM, MCI and fibrosis were also found to be statistically significant (P < 0.05, P < 0.05, P < 0.005, respectively). In the comparison of group 2 with group 3, no statistically significant differences were found in terms of the these parameters. Conclusions : Although MMC is toxic at high doses, the antifibrotic effect of the intraurethral low dose MMC may be useful in combination therapy for internal urethrotomy.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Effect of intraurethral Mitomycin‐C on healing and fibrosis in rats with experimentally induced urethral stricture

et al. 2004

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“…It is widespread and has a substantial impact on quality of life and health-care costs. [1] Inflammatory, ischemic, or traumatic processes may result in a scar that can cause an urethral stricture. While urethritis was the most common reason of urethral strictures in 1960s, and 1980s, today urethritis was replaced by urethral strictures caused by transurethral resection of prostate (TURP) and radical prostatectomy especially in patients older than age 45.…”

Section: Introductionmentioning

confidence: 99%

The predictive value of platelet to lymphocyte and neutrophil to lymphocyte ratio in determining urethral stricture after transurethral resection of prostate

Gül¹,

Altintas²,

Kaynar³

et al. 2017

Turkish Journal of Urology

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Objective: The pathology of urethral stricture disease is still unclear however progressive inflammation may contribute to the development of urethral stricture. The platelet-to-lymphocyte ratio (PLR) is a new and simple marker that indicates inflammation. In this study we aimed to investigate the predictive value of neutrophil to lymphocyte ratio (NLR) and PLR in patients with urethral stricture who underwent transurethral resection of prostate (TURP). Material and methods:A total of 208 patients who underwent bipolar-TURP were included in this study. Patients who had previously undergone surgery due to any urethral pathology, posterior urethral strictures, previous or ongoing treatment for any cancer, hematologic disorders, presence of an active infection at the time of surgical intervention, and prior blood transfusion were excluded. PLR, NLR and red cell distribution width (RDW) levels were measured. In order to investigate the predictive values of NLR and PLR variables, binary logistic regression analysis was performed. Results:No statistically significant differences were observed between the groups in terms of age, NLR, RDW, prostate size and operative times. Statistically significant differences were presented only in the median PLR-values. For predicting urethral stricture, the optimal cut-off value was 112.5, (sensitivity: 0.84, specificity: 0.64; AUC= 0.762, 95% CI 0.684-0.84). Conclusion:In this study we showed that PLR can be used to determine urethral stricture as a cost-effective, common, and simple biomarker in patients after TURP.Keywords: Inflammation; neutrophil to lymphocyte ratio; platelet to lymphocyte ratio; urethral stricture.Cite this article as: Gül M, Altıntaş E, Kaynar M, Buğday MS, Göktaş S. The predictive value of platelet to lymphocyte and neutrophil to lymphocyte ratio in determining urethral stricture after transurethral resection of prostate. Turk J Urol 2017; 43: 325-9

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“…[2] Success rates following DVIU have been shown to vary between 30% and 90% [3][4][5][6] , depending on the length and location of the stricture. [7,8] Patients are usually left with an indwelling urethral catheter for 3-7 days after DVIU; however there is no consensus on the duration of the catheterization.…”

Section: Introductionmentioning

confidence: 99%

Catheter dwell time and diameter affect the recurrence rates after internal urethrotomy

Yürük

Yentur

Çakır

et al. 2016

Turkish Journal of Urology

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Objective: Cold-knife direct vision internal urethrotomy (DVIU) is frequently used as the first-line treatment for urethral stricture disease. Although the steps of the procedure are defined in detail, the duration of catheterization and the diameter of the catheter to be used after the operation are not clearly defined. The aim of this study is to evaluate the effects of catheter dwell time and diameter on recurrence rates of urethral stricture disease after DVIU. Material and methods:Data of 193 consecutive treatment naïve bulbar urethral stricture patients who underwent DVIU between January 2009 and June 2013 were retrospectively analyzed. Patient demographics and stricture characteristics were noted. Catheter dwell times were grouped as <5 and ≥5 days. The diameters of catheters used were 16, 18 and 22 Fr. The association between recurrence rates, catheter dwell times, and diameter were evaluated with Tukey's test and Pearson's correlation test, respectively. Results:Overall 193 patients with a mean age of 64.51±12.99 (range: 17 to 85) years were enrolled in the study. Urethral stricture disease recurred in 45 (23.31%) patients within the first year after DVIU. Mean duration of catheterization was 7.47±4.03 and 4.79±1.94 days in patients with and without recurrences, respectively (p=0.0001). Catheter dwell times for ≥5 days were also associated with increased recurrence (p=0.0001). Of the patients with recurrent strictures, 16, 18 and 22Fr catheters were placed in 22.22%, 20% and 57.78% of the patients, respectively. Increased catheter diameter was also associated with higher recurrence rates (p=0.004). Conclusion:Shortening the postoperative duration of catheterization and decreasing the catheter size may result in improved recurrence rates after DVIU. Further prospective randomized trials are necessary to confirm these findings.

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Newly Diagnosed Bulbar Urethral Strictures: Etiology and Outcome of Various Treatments

Cited by 60 publications

References 15 publications

Effect of intraurethral Mitomycin‐C on healing and fibrosis in rats with experimentally induced urethral stricture

Effect of intraurethral Mitomycin‐C on healing and fibrosis in rats with experimentally induced urethral stricture

The predictive value of platelet to lymphocyte and neutrophil to lymphocyte ratio in determining urethral stricture after transurethral resection of prostate

Catheter dwell time and diameter affect the recurrence rates after internal urethrotomy

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