Urethroplasty for Stricture Disease: Contemporary Techniques and Outcomes

Dugi, Daniel; Simhan, Jay; Morey, Allen F.

doi:10.1016/j.urology.2015.12.012

Cited by 13 publications

(15 citation statements)

References 54 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…25 There is also potential for troublesome sexual side effects secondary to anastomotic ischaemia, stricture recurrence, erectile dysfunction and penile shortening. 26 However, multiple studies evaluating patient-reported urethroplasty outcomes have concluded that most patients obtain a significant improvement in urinary symptoms and quality of life while maintaining erectile function. [27][28][29] Despite the high success rates of urethroplasty, repetitive endoscopic procedures remain the most common treatment for urethral strictures in Australia.…”

Section: Surgical Reconstructionmentioning

confidence: 99%

Narrowing in on urethral strictures

Flynn¹,

Ong

Win

et al. 2021

Aust J Gen Pract

View full text Add to dashboard Cite

BackgroundUrethral strictures have affected men for millennia, and they are commonly iatrogenic, idiopathic or traumatic in nature. When left untreated, urethral strictures can devastate the health and function of the urinary tract. For centuries, simple urethral dilation and endoscopic urethrotomy have provided temporary relief. However, in only the past 20 years, urethroplasty has emerged as a curative treatment.

show abstract

Section: Surgical Reconstructionmentioning

confidence: 99%

Narrowing in on urethral strictures

Flynn¹,

Ong

Win

et al. 2021

Aust J Gen Pract

View full text Add to dashboard Cite

show abstract

“…Er was geen verschil in recidiefpercentage bij plastieken met een ventrale of dorsale graft. Dit komt overeen met andere analyses, waarin ook geen verschil tussen ventrale en dorsale grafts werd gevonden [6,13]. Slechts één van de vijf patiënten met in de voorgeschiedenis radiotherapie van de prostaat had een recidief, waarbij een dorsale graftplastiek in de bulbaire urethra werd uitgevoerd.…”

Section: Discussieunclassified

“…Het soort ingreep kan een rol spelen in het ontstaan van verminderde erecties. Dugi III beschrijft een verhoogde kans op erectiele disfunctie bij EPA's door het doornemen van de urethra, waarbij mogelijk vasculaire en zenuwstructuren zijn geraakt [13]. Met een gemiddelde leeftijd van 56 jaar is onze patiëntenpopulatie ouder dan die in de meeste andere analyses.…”

Section: Discussieunclassified

Langetermijnfollow-up en succespercentage van de urethraplastiek

2018

View full text Add to dashboard Cite

Samenvatting De urethraplastiek is de aangewezen behandeling voor langere of recidiverende urethrastricturen. In deze retrospectieve studie werd het succespercentage van 81 urethraplastieken middels excisie en primaire anastomose (EPA) of graftplastiek geanalyseerd, met follow-up van minstens drie maanden. Falen van de plastiek werd gedefinieerd als recidief waarvoor enige vorm van interventie volgde. Met een telefonische enquête en vragenlijst werden de tevredenheid en langetermijncomplicaties geëvalueerd. Het overall succes was 79 %. Voor EPA's en graftplastieken was de ingreep succesvol bij 91,7 % en 72,5 % van de patiënten. Korte bulbaire stricturen kwamen het meest voor. Bij 58,8 % van de recidieven waren voorafgaand meerdere ingrepen verricht voor een urethrastrictuur. Erectiele disfunctie de novo kwam voor bij 22,8 %. Postoperatief bemerkte 14 % verkorting van de penis en 6 % kromstand. De conclusie is dat het succespercentage van EPA's hoger is dan van graftplastieken. Meerdere voorafgaande instrumentaties voor strictuurbehandeling is mogelijk een risicofactor voor recidief. Erectiele disfunctie lijkt een veel voorkomende complicatie. Trefwoorden urethrastrictuur • urethraplastiek • succespercentage Long-term follow-up and success rate of the urethroplasty Abstract Long and recurrent urethral strictures are treated with urethroplasty. We retrospectively analyzed 81 urethroplasties performed with excision and anastomosis (EPA) or graft urethroplasty, with at least three months follow-up. Failed urethroplasty was defined as recurrence followed by any intervention. Patient's satisfaction and long-term complications were evaluated with a telephone survey and a written questionnaire. The overall success rate was 79%, in EPAs 91.7% and in graft urethroplasties 72.5%. Most strictures were short and developed in the bulbar urethra. Within the recurrence group 58.8% had undergone multiple previous treatments for urethral strictures. After surgery 22.8% had erectile dysfunction. Shortening of the penis was noticed in 14% and chordee in 6%. In conclusion, the success rate in EPAs is greater than in graft urethroplasties. Multiple treatments for previous urethral strictures could be a risk factor for recurrence. Erectile dysfunction might be an important complication.

show abstract

“…Generally, the management of pelvic fracture urethral injury (PFUI) continues to evolve but has remained a challenge. Short-term and long-term outcomes of its management have much improved in the last 2 decades (1). While some surgeons practice early realignment, others prefer delayed reconstruction of the stricture that develops with the healing of the injury (2).…”

Section: Introductionmentioning

confidence: 99%

Partial Inferior Pubectomy in the Delayed Repair of Pelvic Fracture Urethral Injury: Adopting a Bone-nibbling Technique

Nnabugwu¹,

Ugwumba²,

Ilukwe³

2021

Ann Afr Surg.

View full text Add to dashboard Cite

Background: The use of wedge inferior pubectomy can be challenging to many urethral surgeons. Our objective was to introduce a bone-nibbling technique to accomplish a partial inferior pubectomy (PIP) in a resource-poor setting, and to report the medium- to longterm outcome of using the technique. Methods: Five patients were recruited (mean age: 38.8 years) who presented, over a 30-month period, with posterior urethral fibrosis from a pelvic fracture urethral injury (PFUI). One had failed a previous attempt at posterior urethral reconstruction elsewhere. The length of urethral defect was from 2 to 4 cm. We describe a bone-nibbling technique used to carry out PIP for the delayed repair of PFUI in these patients. The outcomes in the medium to long term of surgical procedures done with this technique are presented. Results: Immediate postoperative complications in all were essentially a Clavien–Dindo grade I. Peak flow rate assessed 12 weeks’ post operation was between 20 mL/s and 23 mL/s (mean: 21 mL/s). The longest duration of follow-up was 34 months, and all patients were voiding satisfactorily. Conclusions: A satisfactory and durable outcome can be obtained from nibbling at the bone from the inferior margin of the pubic bone to achieve PIP. This is of interest to lower urinary tract reconstructive surgeons who have concerns with chiseling-out wedge of the inferior pubis. Keywords: Bone nibbling, Partial inferior pubectomy, PFUI, Posterior urethra, Urethral anastomosis

show abstract

Urethroplasty for Stricture Disease: Contemporary Techniques and Outcomes

Cited by 13 publications

References 54 publications

Narrowing in on urethral strictures

Narrowing in on urethral strictures

Langetermijnfollow-up en succespercentage van de urethraplastiek

Partial Inferior Pubectomy in the Delayed Repair of Pelvic Fracture Urethral Injury: Adopting a Bone-nibbling Technique

Contact Info

Product

Resources

About