Direct Vision Internal Urethrotamy. A Critical Review of 365 Operations

Holm-Nielsen, Anders; Schultz, Alexander; Møller-Pedersen, V.

doi:10.1111/j.1464-410x.1984.tb05393.x

Cited by 91 publications

(43 citation statements)

References 14 publications

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“…In our study, in 76.7% patients, the response to optical urethrotomy was good while 6 out of 23 were having poor response. These were quite comparable with Holm Nielsen et al [11] reported success rate 77% & Pansadoro V reported 11% poor results. [12] CONCLUSION During a 5-year period urethral strictures in 23 patients with associated co morbidities were treated by cold knife urethrotomy.…”

Section: Discussionsupporting

confidence: 88%

Is Direct Vision Internal Urethrotomy a Viable Option for Treating Urethral Strictures in Patients with Morbidities: Our Experience

Bhat¹,

Roy²,

Rai³

et al. 2017

AIMDR

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Background: Direct visual internal urethrotomy (DVIU) and urethral dilatation are the most commonly performed procedures for urethral stricture disease. This approach is appealing both for urologists and patients as it is minimally invasive. The objective of this paper is to outline the current scientific evidence supporting this approach for its use in the management of urethral strictures in patients with multiple morbidities who would not tolerate prolonged surgeries well and to share our own experiences. Methods: We performed a retrospective study of cystoscopy-guided internal urethrotomies performed between 2009 and 2014 on patients with co morbid conditions. Results: Overall, urethral stricture stabilized in 76.7% of patients with 1 or 2 internal urethrotomies within 24 months of follow-up.Conclusion: Direct vision cold knife urethrotomy is a safe technique that should be exercised as a therapeutic trial in patients with co morbidities as an alternative giving a safer and easier option.

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Section: Discussionsupporting

confidence: 88%

Is Direct Vision Internal Urethrotomy a Viable Option for Treating Urethral Strictures in Patients with Morbidities: Our Experience

Bhat¹,

Roy²,

Rai³

et al. 2017

AIMDR

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“…With the rise of endoscopic equipment firstly were used in 1865 and IU widely was accepted fort the initial management of short segmental urethral stricture (6). The long term and short term results of IU have been evaluated and the success rate reported as 23-83% in several articles (7,8).…”

Section: Discussionmentioning

confidence: 99%

The Long-term Effect of Uretral Dilatation Therapy Combined with Steroid After Internal Urethrotomy

Yeşil¹

2013

gmj

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Objective: To present the long-term results of hydrophilic dilatation catheter or steroid-coated hydrophilic dilatation catheter usage in the management of primary urethral stricture. Methods: Forty-one male patients with a diagnosis of primary urethral stricture shorter than 1.5 cm and no comorbities were included in this study. After application of internal uretrotomy, these patients were randomized into two groups. A steroid-coated (triamcinolone acetonide (1%) 18F hydrophilic dilatation catheter was applied to the patients in group 1 for 2 weeks and an 18F hydrophilic dilatation catheter was applied to the patients in group 2 for 2 weeks, and catheters were removed after 3 days. Uroflowmetry and recurrence rate was used in postoperative follow-ups. Results: Mean patient age were respectively 45.1±8.0 and 47±8.8(68-29) years. Urethral stricture length was evaluated for group 1 7.4±4.0 mm and group 2 7.8±4.3 mm p:0.79. All patients uroflowmetry value (Q max) were followed up on 6,12,24 and 36 month and results were evaluated. Recurrence of urethral stricture was determined in 3 (13%) patients in group 1, and 3 (15%) patients in group 2 (p<0.05) and statisticaly significant. Conclusions: 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.

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“…However, they did not mention how they decided the duration of catheterization and the size of the silicone catheter used. On the other hand, Holm-Nielsen et al [17] , reported an overall cure rate of 77% in the management of 369 strictures in 225 patients and concluded that although an active follow-up with periodic urethroscopic examinations affected the outcome of DVIU; postoperative period of catheterization and positive urine culture at the time of follow-up had no significant influence on the results. As we do not routinely initiate a urethral dilation program after removal of the urethral catheter, we have not enough data to evaluate the effects of post-DVIU dilation on the recurrence rates.…”

Section: Discussionmentioning

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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Direct Vision Internal Urethrotamy. A Critical Review of 365 Operations

Cited by 91 publications

References 14 publications

Is Direct Vision Internal Urethrotomy a Viable Option for Treating Urethral Strictures in Patients with Morbidities: Our Experience

Is Direct Vision Internal Urethrotomy a Viable Option for Treating Urethral Strictures in Patients with Morbidities: Our Experience

The Long-term Effect of Uretral Dilatation Therapy Combined with Steroid After Internal Urethrotomy

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

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