The Short-Term Efficacy of Dilatation Therapy Combined with Steroid After Internal Urethrotomy in the Management of Urethral Stenoses

Gücük, Adnan; Tuygun, Can; Burgu, Berk; Öztürk, Ufuk; Dede, Onur; İmamoğlu, Abdurrahim

doi:10.1089/end.2009.0233

Cited by 25 publications

(26 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Etiologic factors for urethral stricture disease include perineal trauma, urethral catheterization, urologic instrumentation, chronic inflammatory diseases such as lichen sclerosus, and sexually transmitted diseases. However, most cases of urethral strictures are idiopathic, and most patients probably have unrecognized childhood trauma [6]. The first identifiable change in urethral stricture disease is a change in the nature of the urethral epithelium from a pseudo-stratified columnar epithelium to a columnar epithelium that lacks the waterproofing quality of the pseudo-stratified variant.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Holmium Laser Urethrotomy in Combination with Intralesional Triamcinolone in the Treatment of Anterior Urethral Stricture

et al. 2012

View full text Add to dashboard Cite

PurposeTo evaluate the outcome of visual internal urethrotomy with a holmium:yttrium-aluminum-garnet laser along with intralesional triamcinolone injection.Materials and MethodsPatients with an anterior urethral stricture less than 3 cm in length were evaluated by clinical history, physical examination, uroflowmetry, and retrograde urethrogram preoperatively. All patients were treated with holmium laser urethrotomy and intralesional triamcinolone (80 mg) injection under general or regional anesthesia. An 18 F urethral catheter was placed for 5 days. All patients were followed up for 12 months postoperatively by history, uroflowmetry, and if required, retrograde urethrogram or urethroscopy every 3 months.ResultsThe mean age of the patients was 42.9 years (range, 14 to 70 years). The overall recurrence rate was 24%. The success rate in patients with strictures less than 1 cm in length was 95.8%, whereas that in patients with strictures of 1 to 3 cm in length was 57.7% (p=0.002). The outcome did not depend on age, duration of symptoms, etiology, or location of stricture.ConclusionsHolmium laser urethrotomy with intralesional triamcinolone is a safe and effective minimally invasive therapeutic modality for urethral strictures. This procedure has an encouraging success rate, especially in those with stricture segments of less than 1 cm in length.

show abstract

Section: Discussionmentioning

confidence: 99%

Efficacy of Holmium Laser Urethrotomy in Combination with Intralesional Triamcinolone in the Treatment of Anterior Urethral Stricture

et al. 2012

View full text Add to dashboard Cite

show abstract

“…Over the past 20 years, improvements in endoscopic surgery have contributed to the success rate of urethral stricture surgery [10,11,16-18]. Triamcinolone, mitomycin-C, transforming growth factor beta oligodeoxynucleotide, and gene therapy-such as recombinant adenovirus and retrovirus gene transfer-have also been used as adjuvant treatment [17,18].…”

Section: Discussionmentioning

confidence: 99%

“…Gücük et al used a steroid-coated (triamcinolone acetonide 1%) 18 F hydrophilic dilatation catheter in post-VIU patients [10]. The steroids, which induce a fibroblast reaction, suppressed (experimentally and clinically) a decrease in the accumulation of collagen fibers and fibroblasts and inhibited the proliferation of fibroblasts in wound tissue.…”

Section: Discussionmentioning

confidence: 99%

Early Experience with Hyaluronic Acid Instillation to Assist with Visual Internal Urethrotomy for Urethral Stricture

et al. 2010

View full text Add to dashboard Cite

PurposeThe clinical usefulness of hyaluronic acid (HA) instillation during visual internal urethrotomy (VIU) for decreasing the incidence of recurrent urethral stricture was assessed.Materials and MethodsTwenty-eight patients were treated by VIU with HA instillation between May 2007 and June 2009. After insertion of a Foley catheter following urethrotomy, HA was instilled via an 18-gauge tube catheter between the urethral lumen and Foley catheter. Seventeen cases were analyzed retrospectively 12 months postoperatively. We evaluated the success rate of this procedure by comparing retrograde urethrography (RGU) results, maximum flow rates, and postvoid residual urine volumes preoperatively and 3 and 12 months postoperatively. Success was defined as either a maximum flow rate of at least 15 ml/s or no visible urethral stricture on RGU at 12 months postoperatively.ResultsTotal success rates were 76.5% (13/17) and 52.9% (9/17) at 3 and 12 months postoperatively, respectively. By etiology, success rates at 3 and 12 months postoperatively, respectively, were 66.7% and 33.3% for inflammation, 66.7% and 50.0% for trauma, and 83.3% and 66.7% for unknown causes. Success rates were 63.6% for strictures less than 10 mm in length and 33.3% for strictures of 10 mm or more in length at 12 months postoperatively. Success rates were 61.5% for single strictures and 25% for multiple strictures at 12 months postoperatively.ConclusionsThe success rate of VIU with HA instillation was not better than that observed in the literature for conventional VIU.

show abstract

“…Gücük et al (19) reported that although there was no statistically significant difference in patients who retained the 18 Fr steroid-coated hydrophilic catheters for 2 weeks after internal urethrotomy, there was some increase in the operative maximum flow rate. Table 2.…”

Section: Discussionmentioning

confidence: 99%

“…In this study where we did not find a significant difference, we also recommend to not prolong the postoperative urinary catheterization time and to remove it as quickly as possible. We recommend that the probe duration be at least 3 days due to the poor comfort it provides to the patient as well as the increased risk of infection as previously mentioned in the literature because a long postoperative urinary catheter time may lead to the emergence of recurrent stenosis, thus causing ischemic damage in the urethral mucosa (19). We also suggest that the urinary catheter time can be kept longer relying on the surgeon's experience in stenoses longer than 1 cm and traumatic stenoses that require recurrent urethrotomies.…”

Section: Urinarymentioning

confidence: 97%

Urinary Catheterization for Urethral Stricture, Whom and How Long?

Horsanalı¹,

Balcı²,

Ozer³

et al. 2015

JAREM

View full text Add to dashboard Cite

Objective: Narrowing of the urethral lumen due to fibrosis, which occurs in the urethral mucosa and the surrounding tissue, is defined as urethral stricture. Even though the most common reason for urethral stricture is idiopathic, trauma and iatrogenic applications can also cause urethral stricture. In this study, we analyzed the association between recurrent stricture and urinary catheterization duration in patients who underwent direct vision internal urethrotomy for urethral stricture.Methods: In our clinic, in 2014, we analyzed 157 patients who underwent direct vision internal urethrotomy with a cold knife for urethral stricture. All patients were divided into the following three groups as 3 days, 5 days, and 7 days after the operation in terms of urinary catheterization duration. To analyze the association between recurrent and postoperative Qmax values, Chi-square test and one-way analysis of variance (ANOVA) were performed.Results: The mean age of 157 patients was 63.51±13.86 years. The mean preoperative Qmax, stricture length, and postoperative Qmax values of all patients were 6.07±2.70 mL/s, 2.61±2.19 cm, and 10.9±4.1 mL/s, respectively. Additionally, 49 (31.2%) patients had recurrent stricture and 108 (68.8%) patient had no recurrence. In total, 17 (36%) patients in the 3-day postoperative urinary catheterization group, 12 (22%) in the 5-day group, and 20 (35%) in the 7-day group had recurrent stricture. Statistical analyses revealed no statistical significance between groups in terms of recurrent stricture and postoperative Qmax values.Conclusion: Currently, the recommended gold standard treatment for urethral stricture is direct vision internal urethrotomy. In the literature, many studies have compared surgical techniques and results. In our study, we found no statistical significance between urinary catheterization duration (3, 5, or 7 days postoperatively) in patients who underwent direct vision cold knife internal urethrotomy. The duration of postoperative urinary catheterization should not be extended; we recommend that remove it as soon as possible. After the operation, we believe that urinary catheterization must remove reasonable period of time, so patient comfort can be increased and urinary catheterization for recurrent strictures that develop due to remaining for a long time, could have been avoided. (JAREM 2015; 5: 121-4)

show abstract

The Short-Term Efficacy of Dilatation Therapy Combined with Steroid After Internal Urethrotomy in the Management of Urethral Stenoses

Abstract: As an adjuvant treatment, this method is effortless, low in complications, and hopeful. Certainly, application to larger patient populations is needed to objectively accept its efficiency.

Cited by 25 publications

References 21 publications

Efficacy of Holmium Laser Urethrotomy in Combination with Intralesional Triamcinolone in the Treatment of Anterior Urethral Stricture

Efficacy of Holmium Laser Urethrotomy in Combination with Intralesional Triamcinolone in the Treatment of Anterior Urethral Stricture

Early Experience with Hyaluronic Acid Instillation to Assist with Visual Internal Urethrotomy for Urethral Stricture

Urinary Catheterization for Urethral Stricture, Whom and How Long?

Contact Info

Product

Resources

About