Johanson&amp;rsquo;s Staged Urethroplasty Revisited in the Salvage Treatment of 68 Complex Urethral Stricture Patients: Presentation of Total Urethroplasty

Al-Ali, Muneer; Al-Hajaj, R.

doi:10.1159/000052451

Cited by 27 publications

(9 citation statements)

References 5 publications

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“…None of our four patients treated by TSU suffered a recurrence. Other authors 28,29 also obtained excellent success rates (>90%). TSU can thus be a valuable alternative in case of complicated strictures.…”

Section: Discussionmentioning

confidence: 78%

Urethroplasty for urethral strictures: Quality assessment of an in‐home algorithm

2010

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Objectives: To evaluate the outcome of different techniques of urethroplasty and to assess the quality of an in-home algorithm. Methods: Two hundred fifty-two male patients underwent urethroplasty. Mean patient's age was 48 years (range 1-85 years). Data were analyzed for the failure rate of the different techniques of urethroplasty. An additional analysis was done based on an in-home algorithm. Results: Median follow up was 37 months (range: 6-92 months). Global failure rate was 14.9%, with an individual failure rate of 11.7%, 16.0%, 20.7% and 20.8% for anastomotic repair, free graft urethroplasty, pedicled flap urethroplasty and combined urethroplasty, respectively. In free graft urethroplasty, results were significantly worse when extrapreputial skin was used. Anastomotic repair was the principle technique for short strictures (83.3%), at the bulbar and posterior urethra (respectively 50.8 and 100%). Free graft urethroplasty was mainly used for 3-10 cm strictures (58.6%). Anastomotic repair and free graft urethroplasty were more used in case of no previous interventions or after urethrotomy/dilation. Pedicled flap urethroplasty was the main technique at the penile urethra (40.7%). Combined urethroplasty was necessary in 41 and 47.1% in the treatment of, respectively, >10 cm or panurethral/multifocal anterior urethral strictures and was the most important technique in these circumstances. Two-stage urethroplasty or perineostomy were only used in 2% as first-line treatment but were already used in 14.9% after failed urethroplasty. Conclusion: Urethroplasty has good results at intermediate follow up. Different types of techniques must be used for different types of strictures.

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Section: Discussionmentioning

confidence: 78%

Urethroplasty for urethral strictures: Quality assessment of an in‐home algorithm

2010

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“…Obliterative strictures do not do well with a ‘stricturotomy and patch’, in our view, and alternative approaches must be considered. Staged reconstructions come into their own with full‐length strictures and with salvage surgery [114] (Fig. 31).…”

Section: Difficult Situationsmentioning

confidence: 99%

Urethral strictures

Mundy¹,

Andrich²

2010

BJU International

339

265

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What’s known on the subject? and What does the study add? Urethral strictures are common and increasingly common in an ageing population. The treatment is controversial and particularly the relative roles of urethrotomy or urethral dilatation on the one hand and urethroplasty on the other. This review aims to provide a comprehensive overview of the subject including less commonly discussed issues such as the history and pathology of stricture disease. We would hope that a comprehensive overview of the subject will give a sharper perspective to aid the investigation and management of patients with urethral strictures.

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“…Although the Johanson staged urethroplasty has long fallen out of favor as a first-line therapy, it is still a good surgical option for difficult and complicated urethral strictures, especially those in the pendulous part [62]. In strictures involving all parts of the urethra, total urethroplasty could be performed [62]. …”

Section: Management Of Panurethral Stricturementioning

confidence: 99%

Current Management of Urethral Stricture

Lee

Kim

2013

Korean J Urol

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The surgical treatment of urethral stricture diseases is continually evolving. Although various surgical techniques are available for the treatment of anterior urethral stricture, no one technique has been identified as the method of choice. This article provides a brief updated review of the surgical options for the management of different sites and different types of anterior urethral stricture. This review also covers present controversies in urethral reconstruction. Among the various procedures available for treating urethral stricture, one-stage buccal mucosal graft urethroplasty is currently widely used. The choice of technique for urethroplasty for an individual case largely depends on the expertise of the surgeon. Therefore, urologists working in this field should keep themselves updated on the numerous surgical techniques to deal with any condition of the urethra that might surface at the time of surgery.

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Johanson’s Staged Urethroplasty Revisited in the Salvage Treatment of 68 Complex Urethral Stricture Patients: Presentation of Total Urethroplasty

Cited by 27 publications

References 5 publications

Urethroplasty for urethral strictures: Quality assessment of an in‐home algorithm

Urethroplasty for urethral strictures: Quality assessment of an in‐home algorithm

Urethral strictures

Current Management of Urethral Stricture

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