SIU/ICUD Consultation on Urethral Strictures: Epidemiology, Etiology, Anatomy, and Nomenclature of Urethral Stenoses, Strictures, and Pelvic Fracture Urethral Disruption Injuries

Latini, Jerilyn M.; McAninch, Jack W.; Brandes, Steven B.; Chung, Jae Yong; Rosenstein, Daniel

doi:10.1016/j.urology.2013.09.009

Cited by 177 publications

(168 citation statements)

References 10 publications

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“…Previously, this was termed bladder neck contracture, however stenosis is the more pathologically descriptive and accurate term and is now used in place of contracture. 3 While the historically reported incidence of VUAS after RP was as high as 30%, most contemporary series demonstrate a much more modest rate of less than 5%. [4][5][6][7] No consensus exists for the management of VUAS following prostatectomy.…”

Section: Introductionmentioning

confidence: 99%

An update on best practice in the diagnosis and management of post-prostatectomy anastomotic strictures

Rocco

Zuckerman

2017

Therapeutic Advances in Urology

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Postprostatectomy vesicourethral anastomotic stenosis (VUAS) remains a challenging problem for both patient and urologist. Improved surgical techniques and perioperative identification and treatment of risk factors has led to a decline over the last several decades. High-level evidence to guide management is lacking, primarily relying on small retrospective studies and expert opinion. Endourologic therapies, including dilation and transurethral incision or resection with or without adjunct injection of scar modulators is considered first-line management. Recalcitrant VUAS requires surgical reconstruction of the vesicourethral anastomosis, and in poor surgical candidates, a chronic indwelling catheter or urinary diversion may be the only option. This review provides an update in the diagnosis and management of postprostatectomy VUAS.

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Section: Introductionmentioning

confidence: 99%

An update on best practice in the diagnosis and management of post-prostatectomy anastomotic strictures

Rocco

Zuckerman

2017

Therapeutic Advances in Urology

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“…In Sub-Saharan Africa however, the incidence is probably higher as strictures resulting from postinfectious etiologies particularly postgonococcal urethritis remains an important contributor to the disease's burden. [1] In addition, iatrogenic strictures from inappropriate urethral catheterizations and urethral instrumentations are increasingly seen. [2] As a result, strictures seen in the region are often long and complex thus requiring definitive urethroplasty.…”

Section: Introductionmentioning

confidence: 99%

Impact of preoperative patient characteristics on posturethroplasty recurrence: The significance of stricture length and prior treatments

Bello

2016

Niger J Surg

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Introduction:Urethral strictures are common in urologic practice of Sub-Saharan Africa including Nigeria. We determine the rate of stricture recurrence following urethroplasty for anterior urethral strictures and evaluate preoperative variables that predict of stricture recurrence in our practice.Subjects and Methods:Thirty-six men who had urethroplasty for proven anterior urethral stricture disease between February 2012 and January 2015 were retrospectively analyzed. Preoperative factors including age, socioeconomic factors, comorbidities, etiology of strictures, stricture location, stricture length, periurethral spongiofibrosis, and prior stricture treatments were assessed for independent predictors of stricture recurrence.Results:The median age was 49.5 years (range 21-90), median stricture length was 4 cm (range 1-18 cm) and the overall recurrence rate was 27.8%. Postinfectious strictures, pan urethral strictures or multiple strictures involving the penile and bulbar urethra were more common. Most patients had penile circular fasciocutaneous flap urethroplasty. Following univariate analysis of potential preoperative predictors of stricture recurrence, stricture length, and prior treatments with dilations or urethrotomies were found to be significantly associated with stricture recurrence. On multivariate analysis, they both remained statistically significant. Patients who had prior treatments had greater odds of having a recurrent stricture (odds ratio 18, 95% confidence interval [CI] 1.4–224.3). Stricture length was dichotomized based on receiver operating characteristic (ROC) analysis, and strictures of length ≥5 cm had significantly greater recurrence (area under ROC curve of 0.825, 95% CI 0.690–0.960, P = 0.032).Conclusion:Patients who had prior dilatations or urethrotomies and those with long strictures particularly strictures ≥5 cm have significantly greater odds of developing a recurrence following urethroplasty in Nigerian urology practice.

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“…Urethral stricture is a scarring process of the urethral mucosa and surrounding spongy tissues of the corpus spongiosum (Latini et al, 2014). The male urethra is divided into four parts: prostatic, membranous, bulbar, and penile urethra.…”

Section: Introductionmentioning

confidence: 99%

“…Instrumentation is a possible cause of injury to the urethral mucosa. The partial loss of urethral mucosa represents the initiation of the scarring process of the corpus spongiosum or spongiofibrosis (Latini et al, 2014). Other causes of strictures include prior hypospadias repair, urethral catheterization (prolonged or traumatic) related to non-urologic conditions, blunt or penetrating external trauma, and idiopathic causes (Lumen et al, 2009).…”

Section: Introductionmentioning

confidence: 99%

Erectile dysfunction in urethral stricture and pelvic fracture urethral injury patients: diagnosis, treatment, and outcomes

2015

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SUMMARYUrethral stricture disease, pelvic fracture urethral injury (PFUI), and their various treatment options are associated with erectile dysfunction (ED). The etiology of urethral stricture disease is multifactorial and includes trauma, inflammatory, and iatrogenic causes. Posterior urethral injuries are commonly associated with pelvic fractures. There is a spectrum in the severity of both conditions and this directly impacts the treatment options offered by the surgeon. Many published studies focus on the treatment outcomes and the relatively high recurrence rates after surgical repair. This communication reviews the current knowledge of the association between ED and urethral stricture disease, as well as PFUI. The incidence, pathophysiology, and clinical ramifications of both conditions on sexual function are discussed. The treatment options for ED in those patients are reviewed and summarized.

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SIU/ICUD Consultation on Urethral Strictures: Epidemiology, Etiology, Anatomy, and Nomenclature of Urethral Stenoses, Strictures, and Pelvic Fracture Urethral Disruption Injuries

Cited by 177 publications

References 10 publications

An update on best practice in the diagnosis and management of post-prostatectomy anastomotic strictures

An update on best practice in the diagnosis and management of post-prostatectomy anastomotic strictures

Impact of preoperative patient characteristics on posturethroplasty recurrence: The significance of stricture length and prior treatments

Erectile dysfunction in urethral stricture and pelvic fracture urethral injury patients: diagnosis, treatment, and outcomes

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