Narrowing in on urethral strictures

Flynn, Hannah; Ong, Michelle; Win, Gunter De; Desai, Devang

doi:10.31128/ajgp-03-20-5280

Cited by 6 publications

(8 citation statements)

References 27 publications

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“…In proximal biopsies, at 1 cm, 93.3% ( 14 ) showed scarring and 33.3% ( 5 ) inflammatory cells present, 46.7% ( 7 ) had epidermal thickening, 26.7% ( 4 ) had hyperkeratosis and one patient had epidermal atrophy. No patients displayed ulcerative changes ( Table S4 ).…”

Section: Resultsmentioning

confidence: 97%

“…At 2 cm distally, again no LS was seen, while 93.3% ( 14 ) had scarring, 40% ( 6 ) had inflammatory cells present and 33.3% ( 5 ) had epidermal thickening ( Table S3 ). No ulcerations were observed at this location.…”

Section: Resultsmentioning

confidence: 99%

“…Additionally, 93.3% ( 14 ) had evidence of scarring, 26.7% ( 4 ) had inflammatory cells present, and no patients exhibited ulcerations. Hyperkeratosis was present in 20% ( 3 ), 33.3% ( 5 ) had epidermal thickening, 1 patient had epidermal atrophy and 1 patient had upper dermal hyalinisation. Again, the patient with PeIN at other sites demonstrated PeIN at this site ( Table S5 ).…”

Section: Resultsmentioning

confidence: 99%

“…Stricture disease is a relatively common condition, with incidence rates of up to 1/1,000 reported in the literature and a prevalence between 0.2% and 0.9% ( 5 ). A similar prevalence rate has been researched locally in two regional centres ( 6 , 7 ).…”

Section: Introductionmentioning

confidence: 99%

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UrethroNAV: the aetiology and extent of idiopathic urethral stricture in an Australian population

Desai,

Harrison,

Raveenthiran

et al. 2024

Transl Androl Urol

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Background Lichen sclerosus (LS) is considered a causative factor in 10% of cases of idiopathic urethral stricture disease (IUSD), which is important for determining management strategies due to the underlying pathophysiology. Traditional excision urethroplasty may not be effective as inflammation often extends beyond the macroscopic stricture. This pilot study aims to answer two research questions: is LS an underlying cause of some idiopathic cause of strictures, and, if there is histological evidence suggesting predisposition of the surrounding tissue to strictures. Methods Biopsies were taken from the stricture site as well as 1 and 2 cm proximal and distal in patients with IUSD. Histological features, including macroscopic and microscopic findings, were reported, including the presence of LS, hyperkeratosis, epidermal changes, lichenoid infiltrates, ulceration, scarring, and inflammation. Methylene blue was used to aid in locating damaged urothelium. Patients were prospectively followed up after urethroplasty. Results From 109 urethroplasties performed between 2019 to 2022, 15 male patients were enrolled after meeting specific inclusion criteria. These criteria included a diagnosis of IUSD and the absence of any evidence of trauma, macroscopic inflammatory disease, or previous endoscopic instrumentation of the urethra. Patients had to be at least 16 years old and medically suitable for undergoing urethroplasty. The study was approved by the hospitals ethics committees. None had macroscopic evidence of LS. One patient had microscopic evidence of LS at the 2 cm proximal biopsy only. A total of 93% of patients had scarring proximal and distal to the stricture, while 20–40% had inflammatory change. The patient with microscopic LS and two inflammatory change patients had stricture recurrence after urethroplasty. Additionally, one patient with inflammatory changes was diagnosed with penile intraepithelial neoplasia (PeIN) and underwent partial penectomy. Conclusions Findings suggest that an underlying cause of IUSD could be LS. Additionally, the pathophysiology may involve scarring and inflammation beyond the limits of the stricture with extension distal from the stricture site. Careful evaluation for concomitant urethral pathology should be considered in cases of inflammatory changes. These findings should be considered in the surgical management of IUSD and warrant further research into the role of routine biopsy and drug targets in USD.

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Section: Resultsmentioning

confidence: 97%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

UrethroNAV: the aetiology and extent of idiopathic urethral stricture in an Australian population

Desai,

Harrison,

Raveenthiran

et al. 2024

Transl Androl Urol

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“…Previously, the most common cause of urethral stricture was urethritis caused by sexually transmitted diseases [8]. In contrast, nowadays, reasons such as TUR, cystoscopy, urethral catheterization, prostatectomy, brachytherapy and hypospadias surgery come to the fore [9].…”

Section: Discussionmentioning

confidence: 99%

The factors affecting occurrence of urethral stricture after transurethral resection of the prostate

Durmuş

Sert

2022

J CLIN MED KAZ

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Objectives: Urethral stricture is one of the complex subjects of urology in terms of high recurrence rates, patient care, treatment difficulties and follow-up. We aimed to evaluate factors associated with the occurrence of urethral stricture after TUR-P (Transurethral resection of the prostate) surgery. Material and methods: In our clinic, 301 patients who underwent TUR-P surgery for benign prostatic hyperplasia (BPH) were analyzed retrospectively. The patients who developed urethral stricture after TUR-P were named Group-1, did not develop were named Group-2. In addition, the patients were compared in terms of demographic and perioperative data.  Results: Urethral stricture was observed in 21 (6.97%) of the patients and not in 280 (93.03%) of them. There was no significant difference between the two groups in terms of age (p=0.913), resectoscope size (p=0.932), energy source type (p=0.932), energy source power (p=0.838), urethral catheter type (p=0.776), urethral catheter size (p=0.973), urethral catheter duration (p=0.797) and urethral catheter traction (p=0.887). Resection time was significantly higher in patients with urethral stricture (53.1±10.8 min vs. 42.2±9.7 min, p<0.001). The preoperative urinary tract infection (UTI) rate was significantly higher in patients with urethral stricture. (76.2% vs 40.0%, p=0.001). The optimum cut-off value for resection time associated with the risk of urethral stricture after TUR-P was 38.5 minutes, with an AUC of 0.812 (95% CI 0.738–0.885). Conclusion: Prolonged resection time and even if treated, preoperative UTI increases the risk of urethral stricture after TUR-P surgery. However, if the resection time is not long, patients are more protected from developing urethral stricture.

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Expertise Area 2.3: Urethral reconstruction in rare diseases and complex conditions

Vetterlein,

Wyndaele,

Campos-Juanatey

et al. 2024

Rare and Complex Urology

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Narrowing in on urethral strictures

Cited by 6 publications

References 27 publications

UrethroNAV: the aetiology and extent of idiopathic urethral stricture in an Australian population

UrethroNAV: the aetiology and extent of idiopathic urethral stricture in an Australian population

The factors affecting occurrence of urethral stricture after transurethral resection of the prostate

Expertise Area 2.3: Urethral reconstruction in rare diseases and complex conditions

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