The Urological Society of India guidelines on management of benign prostatic hyperplasia/benign prostatic obstruction (Executive summary)

Sabnis, Ravindra; Mulawkar, Prashant Motiram; Joshi, Rohit N

doi:10.4103/iju.iju_121_21

Cited by 2 publications

(4 citation statements)

References 33 publications

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“…In the study on the factors affecting the success rates after urethroplasty, Roehborn et al stated that manipulations such as DVUI and dilation before urethroplasty increases the risk of post-operative failure by 2 times [12]. In current urology guidelines, the indication for DVUI is defined as single, non-traumatic bulbar urethral strictures shorter than 1.5 cm, and urethroplasty is recommended instead of DVIU in recurrent urethral strictures [13,14,15]. In our study, 153 (62.5%) patients had no history of DVIU before urethroplasty, 92 (37.5%) patients had a history of DVIU before urethroplasty at least once, and the patency rate in these patients is lower than those without, and the patency rate decreases as the number of DVIU increases.…”

Section: Discussionmentioning

confidence: 99%

Management and outcomes of urethral stricture: single centre experience over 13 years

et al. 2022

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Aim: To present a comprehensive summary of the diagnosis, treatment and follow-up process of patients who underwent open urethroplasty in our tertiary referral center for the treatment of urethral stricture in the last 13 years. Materials and methods: Two hundred and forty-five (245) patients who underwent open urethroplasty between January 2008 and June 2021 were retrospectively analysed. Detailed history, physical examination, uroflowmetry, retrograde urethrography and/or voiding cystourethrography and/or urethroscopy were used throughout the preoperative diagnosis process. While evaluating the postoperative patency rates, the absence of preoperative voiding symptoms after the operation and Qmax 15 ml/sec and above were taken into account. Results: Mean stricture length was 3.8 +/- 1.4 cm. Transurethral endoscopic interventions in 79 patients (32.2%), catheterisation in 55 patients (22.4%), trauma in 54 patients (22%), infection in 15 patients (6.2%), and idiopathology in 42 patients (17.2%) were the causes for the stricture. Buccal mucosal graft was used in 125 patients (51%), penile skin flap in 32 patients (13%), end-to-end anastomosis in 83 patients (33.8%) and Heineke-Mikulicz technique in 5 patients (2%). Mean follow-up period was 67.1 +/- 28.9 months. Success rates of patients were 84% (105) in buccal mucosal graft, 78.1% (25) in penile skin flap, 86.7% (72) with end-to-end anastomosis and 80% (4) with Heineke-Mikulicz technique. Conclusion: Among treatment options for urethral stricture, urethroplasty techniques is the most successful treatment. Consideration of the factors leading to the formation of the stricture, with the intraoperative findings and surgical experience will maximize the benefit the patient receives.

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Section: Discussionmentioning

confidence: 99%

Management and outcomes of urethral stricture: single centre experience over 13 years

et al. 2022

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“…techniques for open reconstruction of the penile urethra may promote a shift toward more successful and more durable single-stage procedures, whereas staged reconstruction remains the cornerstone with good results in highly complex strictures. noncurative) setting [9], and the AUA states that surgeons should offer urethroplasty, except in select cases with previously untreated and short strictures [6]. SIU/ICUD and BAGURS suggest that primary dilation AE DVIU may be used as first-line therapy in unfavorable strictures such as those with penile locations [2].…”

Section: Recent Technical Refinements Of Already Establishedmentioning

confidence: 99%

“…Dilation and urethrotomy should only be considered in patients who are not able to or not willing to undergo open surgery, given that results are poor and nondurable. For penile strictures, the EAU strongly recommends against the use of direct vision internal urethrotomy (DVIU) [10 ▪▪ ], the USI mentions dilation or DVIU only in a palliative (i.e., noncurative) setting [9], and the AUA states that surgeons should offer urethroplasty, except in select cases with previously untreated and short strictures [6]. SIU/ICUD and BAGURS suggest that primary dilation ± DVIU may be used as first-line therapy in unfavorable strictures such as those with penile locations [2].…”

Section: Penile Stricturesmentioning

confidence: 99%

“…The Société Internationale d’Urologie (SIU)/International Consultation on Urologic Diseases (ICUD) and the American Urological Association (AUA) were the first to publish disease-specific recommendations in 2014 [2–5] and 2016 [6]. They were recently followed by the British Association of Genito-Urethral Reconstructive Surgeons (BAGURS) and the Canadian Urological Association in 2020 [7,8], as well as the Urological Society of India (USI) [9] and the European Association of Urology (EAU) in 2021 [10 ▪▪ ].…”

Section: Introductionmentioning

confidence: 99%

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Update on the management of penile and meatal strictures

Vetterlein

Fisch

Zumstein

2021

Current Opinion in Urology

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Purpose of review Treatment of penile and distal urethral strictures including the fossa navicularis and the meatus remains challenging due to their adverse etiology and lack of ventral tissue support. In this contemporary review, we summarize the available evidence and recent advancements in reconstructive techniques. Recent findings Over the last years, several refinements of already established techniques have been added to the reconstructive armamentarium in the management of penile urethral strictures. These include the single-stage combination of flap and graft, the additional use of tissue glue, or an optimized single-stage tubularization using a free graft. Summary There is a shift toward an increased use of single-stage procedures even in complex strictures of the penile and distal urethra. This is reflected by advancements and refinements in operative techniques. Nonetheless, staged urethroplasty remains a cornerstone of curative management in such patients with durable success rates. Future research should focus on identifying distinct patient and stricture characteristics to determine the individual therapeutic approach with optimal functional outcomes.

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The Urological Society of India guidelines on management of benign prostatic hyperplasia/benign prostatic obstruction (Executive summary)

Cited by 2 publications

References 33 publications

Management and outcomes of urethral stricture: single centre experience over 13 years

Management and outcomes of urethral stricture: single centre experience over 13 years

Update on the management of penile and meatal strictures

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