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Urethral stricture

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https://www.readbyqxmd.com/read/27908377/management-of-urethral-strictures
#1
EDITORIAL
Lee C Zhao
No abstract text is available yet for this article.
February 2017: Urologic Clinics of North America
https://www.readbyqxmd.com/read/27908376/urethral-strictures-and-artificial-urinary-sphincter-placement
#2
REVIEW
Jeremy B Myers, William O Brant, James N Hotaling, Sara M Lenherr
Patients undergoing artificial urinary sphincter (AUS) placement often have complex medical and surgical histories, such as radical prostatectomy, endoscopic treatment of urethral strictures, previous AUS placement, and prior open urethral surgery. Urethral strictures at the bladder neck, membranous urethra, or site of a previous AUS erosion are problems that profoundly affect the timing and treatment success of AUS placement. Understanding the complexities and outcomes in this subset of patients is the only way to inform shared decision making about treatment of urinary incontinence...
February 2017: Urologic Clinics of North America
https://www.readbyqxmd.com/read/27908375/treatment-of-radiation-induced-urethral-strictures
#3
REVIEW
Matthias D Hofer, Joceline S Liu, Allen F Morey
Radiation therapy may result in urethral strictures from vascular damage. Most radiation-induced urethral strictures occur in the bulbomembranous junction, and urinary incontinence may result as a consequence of treatment. Radiation therapy may compromise reconstruction due to poor tissue healing and radionecrosis. Excision and primary anastomosis is the preferred urethroplasty technique for radiation-induced urethral stricture. Principles of posterior urethroplasty for trauma may be applied to the treatment of radiation-induced urethral strictures...
February 2017: Urologic Clinics of North America
https://www.readbyqxmd.com/read/27908374/effect-of-lichen-sclerosis-on-success-of-urethroplasty
#4
REVIEW
Michael A Granieri, Andrew C Peterson, Ramiro J Madden-Fuentes
Lichen sclerosis (LS) is a chronic, relapsing disease with a variable presentation. In men, genitourinary LS may affect the penile foreskin, glans, meatus, and urethra. Treatment is multifaceted, ranging from pharmacotherapy to surgery. Urethral reconstruction due to stricture disease from LS is frequently plagued by a high recurrence rate. At the authors' institution, the high recurrence rate has shifted their practice toward potent steroids and minimally invasive surgical techniques. Management of recurrence includes dilation, meatotomy/meatoplasty, 1-stage and 2-stage repairs...
February 2017: Urologic Clinics of North America
https://www.readbyqxmd.com/read/27908372/the-nontransecting-approach-to-bulbar-urethroplasty
#5
REVIEW
Stella Ivaz, Simon Bugeja, Anastasia Frost, Daniela Andrich, Anthony R Mundy
The standard treatment of bulbar urethral strictures of appropriate length is excision and primary anastomosis (EPA), irrespective of the cause of the stricture. This involves transection of the corpus spongiosum (CS) and disruption of the blood flow within the CS as a consequence. The success rate of EPA in curing these strictures is very high, but there is a considerable body of evidence and of opinion to suggest that there is a significant risk of sexual dysfunction and, potentially, of other adverse consequences that occur because of transection of the CS...
February 2017: Urologic Clinics of North America
https://www.readbyqxmd.com/read/27908370/graft-use-in-bulbar-urethroplasty
#6
REVIEW
Mya E Levy, Sean P Elliott
The gold standard for bulbar urethroplasty has been excision and primary anastomosis. Application of this approach is generally limited to strictures that are 2 cm or less in the bulbar urethra due to penile shortening. Strictures greater than 2 cm are successfully treated with augmentation urethroplasty wherein the narrowed segment is not excised but widened with the use of a skin flap or a tissue graft. Buccal mucosa is the most prevalent tissue for bulbar urethral stricture repair for strictures greater than 2 cm...
February 2017: Urologic Clinics of North America
https://www.readbyqxmd.com/read/27908369/patient-selection-for-urethroplasty-technique-excision-and-primary-reanastomosis-versus-graft
#7
REVIEW
Judith C Hagedorn, Bryan B Voelzke
There are many management options for patients with urethral stricture disease. Regarding strictures of the bulbar urethra, ideal management strategies remain controversial. This article reviews important anatomic principles for surgeons to consider when repairing bulbar urethral strictures. Specific presenting features of a bulbar urethral stricture that can serve as a guide for the optimal surgical approach are described. Patient characteristics that are important and may have an impact on the outcome of repair are discussed...
February 2017: Urologic Clinics of North America
https://www.readbyqxmd.com/read/27908368/endoscopic-treatment-of-urethral-stenosis
#8
REVIEW
Brittney H Cotta, Jill C Buckley
Urethral stricture disease continues to be a common problem for patients and urologists alike. Endoscopic treatment offers a simple, potentially effective treatment of primary, short, urethral strictures. For patients who recur after endoscopic management, urethral or bladder neck reconstruction should be offered with an experienced urologic reconstructionist familiar with the complexity of the situation and subtleties of the surgery. With the advent of adjunctive antifibrotic agents the durability of endoscopic repair seems to improve, but their use requires continued research and longer follow-up to determine their efficacy...
February 2017: Urologic Clinics of North America
https://www.readbyqxmd.com/read/27908367/use-of-alternative-techniques-and-grafts-in-urethroplasty
#9
REVIEW
Brendan Michael Browne, Alex J Vanni
The current management for complex urethral strictures commonly uses open reconstruction with buccal mucosa urethroplasty. However, there are multiple situations whereby buccal mucosa is inadequate (eg, pan-urethral stricture or prior buccal harvest) or inappropriate for utilization (eg, heavy tobacco use or oral radiation). Multiple options exist for use as alternatives or adjuncts to buccal mucosa in complex urethral strictures. This article reviews the current state of alternate techniques for urethral stricture treatment besides buccal mucosa, including injectable antifibrotic agents, augmentation urethroplasty with skin flaps, lingual mucosa, colonic mucosa, and new developments in tissue engineering for urethral graft material...
February 2017: Urologic Clinics of North America
https://www.readbyqxmd.com/read/27908365/cost-effective-strategies-for-the-management-and-treatment-of-urethral-stricture-disease
#10
REVIEW
E Charles Osterberg, Gregory Murphy, Catherine R Harris, Benjamin N Breyer
Following failed endoscopic intervention, the most cost-effective strategy for recurrent urethral stricture disease (USD) is urethroplasty. Inpatient hospital costs associated with urethroplasty are driven by patient comorbidities and postoperative complications. Symptom-based surveillance for USD recurrence will reduce unnecessary diagnostic procedures and cost.
February 2017: Urologic Clinics of North America
https://www.readbyqxmd.com/read/27908364/management-of-urethral-strictures-after-hypospadias-repair
#11
REVIEW
Warren T Snodgrass, Nicol C Bush
Strictures of the neourethra after hypospadias surgery are more common after skin flap repairs than urethral plate or neo-plate tubularizations. The diagnosis of stricture after hypospadias repair is suspected based on symptoms of stranguria, urinary retention, and/or urinary tract infection. It is confirmed by urethroscopy during anticipated repair, without preoperative urethrography. The most common repairs for neourethra stricture after hypospadias surgery are single-stage dorsal inlay graft and 2-stage labial mucosa replacement urethroplasty...
February 2017: Urologic Clinics of North America
https://www.readbyqxmd.com/read/27908363/definition-of-successful-treatment-and-optimal-follow-up-after-urethral-reconstruction-for-urethral-stricture-disease
#12
REVIEW
Bradley A Erickson, George M Ghareeb
The definition of a successful urethroplasty, the lack of need for a secondary procedure, is outdated and must be amended to incorporate objective and subjective outcomes. Success is assigned if a flexible cystoscope can traverse the reconstructed urethra without force. Functional success is assigned if patient-reported outcome measures reveal improvement in voiding symptoms and urinary quality of life. Optimal follow-up strategy allows determination of anatomic and functional outcomes, protects genitourinary health, and prevents excessive invasive testing, unnecessary cost, discomfort, anxiety, and risk...
February 2017: Urologic Clinics of North America
https://www.readbyqxmd.com/read/27904649/fasciocutaneous-flap-reinforcement-of-ventral-onlay-buccal-mucosa-grafts-enables-neophallus-revision-urethroplasty
#13
Stelios C Wilson, John T Stranix, Kiranpreet Khurana, Shane D Morrison, Jamie P Levine, Lee C Zhao
BACKGROUND: Urethral strictures or fistulas are common complications after phalloplasty. Neourethral defects pose a difficult reconstructive challenge using standard techniques as there is generally insufficient ventral tissue to support a graft urethroplasty. We report our experience with local fasciocutaneous flaps for support of ventrally-placed buccal mucosal grafts (BMGs) in phalloplasty. METHODS: A retrospective review of patients who underwent phalloplasty and subsequently required revision urethroplasty using BMGs between 2011 and 2015 was completed...
December 2016: Therapeutic Advances in Urology
https://www.readbyqxmd.com/read/27900218/a-prospective-randomised-controlled-study-comparing-bipolar-plasma-vaporisation-of-the-prostate-to-monopolar-transurethral-resection-of-the-prostate
#14
Ahmed M Elsakka, Hssan H Eltatawy, Khaled H Almekaty, Ahmed R Ramadan, Tarik A Gameel, Yasser Farahat
OBJECTIVES: To compare the safety and efficacy of bipolar transurethral plasma vaporisation (B-TUVP) as an alternative to the 'gold standard' monopolar transurethral resection of the prostate (M-TURP) for the treatment of benign prostatic hyperplasia (BPH) in a prospective randomised controlled study. PATIENTS AND METHODS: In all, 82 patients indicated for prostatectomy were assigned to two groups, group I (40 patients) underwent B-TUVP and group II (42 patients) underwent M-TURP...
December 2016: Arab Journal of Urology
https://www.readbyqxmd.com/read/27895077/acquired-male-urethral-diverticulum-a-rare-entity-treated-in-a-one-stage-procedure
#15
José Carlos Santos, Nidia Rolim, Renato Lains Mota, Hélder Monteiro
Acquired male urethral diverticulum is a rare entity with most of the literature revolving around case reports or small case series. Up to two-thirds of cases are acquired, mostly as a result of trauma, stricture or infection. Infrequently, some cases develop as a complication of urological procedures, or even penile clamping. We present the case of an adult male with lower urinary tract symptoms, recurrent urinary infections and a history of multiple surgeries to treat a complicated perineal fistulae disease...
November 28, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27876114/modified-platelet-rich-plasma-with-transforming-growth-factor-%C3%AE-1-neutralization-antibody-injection-may-reduce-recurrence-rate-of-urethral-stricture
#16
Murat Gul
Urethral stricture is one of the most bothersome urologic disease among urologists and has a substantial impact on quality of life and healthcare costs. Although it can be cured with internal urethrotomy easily, post-surgery stricture recurrence is challenging. Several adjuvant therapies have been used in conjunction with internal urethrotomy but none of them are used routinely because the pathophysiology of the disease is still obscure. Fibrosis is the most accused hypothesis for the action. Platelet-rich plasma (PRP) is an autologous blood product containing a high concentration of platelets that is being used for a very wide range of clinical healing applications...
December 2016: Medical Hypotheses
https://www.readbyqxmd.com/read/27871828/pain-associated-with-urethral-catheterization-is-reduced-in-males-by-simultaneous-voiding-maneuver
#17
Kobi Stav, Yishai H Rappaport, Ilia Beberashvili, Amnon Zisman
OBJECTIVE: To assess whether urethral pain during male catheterization can be reduced if the patient is instructed to void during the insertion of the catheter. METHODS: 96 males (age 66±13) who were referred for multichannel Urodynamic study were prospectively randomized to 2 groups according to the catheter insertion technique: (1) patients were instructed to void during catheterization; (2) no guidance prior or during catheterization. Exclusion criteria were: use of analgesics within the previous 24 hours, active urinary tract infection, indwelling urethral catheter, pre-existing urethral pain, known urethral stricture or inability to cooperate with pain assessment due to mental disorders...
November 18, 2016: Urology
https://www.readbyqxmd.com/read/27867812/comparisons-of-oncological-and-functional-outcomes-among-radical-retropubic-prostatectomy-high-dose-rate-brachytherapy-cryoablation-and-high-intensity-focused-ultrasound-for-localized-prostate-cancer
#18
Po Hui Chiang, Yi Yang Liu
PURPOSE: To conduct a retrospective, single institutional and comparative study for radical retropubic prostatectomy (RRP), high dose rate brachytherapy (HDRBT), cryoablation and high-intensity focused ultrasound (HIFU) in localized prostate cancer with respect to oncological and functional outcomes. METHODS: We reviewed 97, 161, 114 and 120 patients of RRP, HDRBT, cryoablation and HIFU respectively for localized prostate cancer from May 2008 to December 2013. PSA biochemical recurrence, salvage treatment-free rate, metastasis-free rate, and biochemical recurrence-free survival were analyzed for oncological outcomes...
2016: SpringerPlus
https://www.readbyqxmd.com/read/27855497/bladder-neck-contracture-after-radical-prostatectomy-what-is-the-reality-of-care
#19
Daniel Pfalzgraf, Fabian Philipp Siegel, Maximilian Kriegmair, Nian Wagener
OBJECTIVES: To evaluate the therapeutic methods and algorithms currently used in the treatment of bladder neck contracture (BNC) after radical prostatectomy. MATERIALS AND METHODS: Heads of 170 urologic departments in Germany, listed at the German Society of Urology (DGU), were invited to participate in an internet-based customized survey. The questions consisted of an epidemiologic part (kind of hospital, state of practice) and questions inquiring used surgical techniques with their respective incidence and given algorithms for therapy...
November 17, 2016: Journal of Endourology
https://www.readbyqxmd.com/read/27845112/re-critical-analysis-of-the-use-of-uroflowmetry-for-urethral-stricture-disease-surveillance
#20
Allen F Morey
No abstract text is available yet for this article.
December 2016: Journal of Urology
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