Impact of Prior Urethral Manipulation on Outcome of Anastomotic Urethroplasty for Post-traumatic Urethral Stricture

Singh, Bhupendra P.; Andankar, Mukund; Swain, Sanjaya; Das, Krishanu; Dassi, Vimal; Kaswan, Harish K.; Agrawal, Vipul; Pathak, H. K.

doi:10.1016/j.urology.2009.06.081

Cited by 67 publications

(37 citation statements)

References 22 publications

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“…Indeed instrumentation includes visual [48] and often using laser vaporisation [46]), transurethral resection [49], even with endoscopic placement of a split-skin graft to supplement the urethrotomy [50][51][52], all with claims of additional benefit; anything, it seems, to avoid a urethroplasty. And when the failures of ePR and its subsequent treatment eventually do come to urethroplasty they skew the results of urethroplasty because the results are not as good as in those who have not had ePR, presumably because of the additional local trauma [53][54][55]. In our experience, there is often cavitation at the site of the original injury and the degree of damage on either side of this is greater than in those who have had an SPC alone (Fig.…”

Section: Fig 8 Augmented Bbasuturing the Two Ends Of The Urethra Amentioning

confidence: 77%

Urethral trauma. Part II: Types of injury and their management

Mundy¹,

Andrich²

2011

BJU International

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Section: Fig 8 Augmented Bbasuturing the Two Ends Of The Urethra Amentioning

confidence: 77%

Urethral trauma. Part II: Types of injury and their management

Mundy¹,

Andrich²

2011

BJU International

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“…5 Due to these high recurrence rates, some clinicians argue that an initial urethrotomy is not beneficial in the long-term care of these patients. 13,14 It has also been suggested that multiple endoscopic treatments can lead to difficult definitive open repairs and reduced overall success rates. [15][16][17] The long-term success rates are overall poor.…”

Section: Discussionmentioning

confidence: 99%

A report on the clinical efficacy of a new Bougie-internal urethrectomy

Jong¹,

Chol²

2015

CUAJ

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Introduction: We compare the clinical efficacy of the new bougieinternal urethrectomy (BIU) with internal urethrotomy and urethroplasty to treat urethral stricture disease. Methods: We prospectively studied 186 people with urethral stricture disease. Of these, 84 were identified for urethroplasty and 102 for internal urethrotomy (endoscopic urethrotomy). Among the 84 identified for urethroplasty, 52 received BIU (Group 1) and the remaining 32 received urethroplasty. Among the 102 identified for internal urethrotomy, 58 received BIU (Group 2) and the remaining 44 received the internal urethrotomy. After surgery, we evaluated the clinical efficacy of the BIU (operative invasions, voiding flow rates, complications, sequelae) compared with the endoscopic treatment and urethroplasty. Results: Patient age ranged from 20 to 70 years. The follow-up period was 2 years. In the BIU Group 1, the BIU Group 2, and the internal urethrotomy (endoscopic treatment), the length of strictures were 2.9 ± 1.5, 2.8 ± 1.3, 1.6 ± 0.7, and 1.5 ± 0.6, respectively. In the BIU Group 1, the urethroplasty, the BIU Group 2, and the internal urethrotomy (endoscopic treatment), the amount of bleeding was 34.1 ± 17.1, 172.2 ± 29.8, 28.5 ± 9.8, and 49.7 ± 13.6 mL, respectively. In the BIU Group 1, the urethroplasty, the BIU Group 2, and the internal urethrotomy, the recurrence rates were 5.8%, 86%, 6.8% and 25%, and the average flow rates were 18.1 ± 4.8, 13.1 ± 3.9, 18.2 ± 3.6, 10.1 ± 3.1 mL/s, respectively. There was no sequealae (sexual dysfunction, penile change) in both BIU groups. Conclusions:The new BIU could be considered first-line treatment in all patients with indications for visual internal urethrotomy and urethroplasty.

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“…Successful out comes from urethrotomy or dilatation requires adequate vascularity within the under lining corpus spongiusom and is more likely to be successful in the bulbar urethra. Whilest et al [42] found up to two internal urethrotomy did not affect the outcomes or likelihood of subsequent anastomotic urethroplasty in patients with posterior injuries. For the anterior urethra using cox hazards regression analysis, failed internal urethrotomy has been found to conform increased risk of failure for consequent urethroplasty [43].…”

Section: Endoscopic Managementmentioning

confidence: 93%