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Issack FH, Hassen SM, Tefera AT, Teshome H, Gebreselassie KH, Mummed FO. Short-term recurrence rate of male urethral stricture and its predictors after treatment with optical internal urethrotomy: Prospective Cohort Study at a tertiary center in Ethiopia. Ann Med Surg (Lond) 2023; 85:4715-4719. [PMID: 37811100 PMCID: PMC10553156 DOI: 10.1097/ms9.0000000000001253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 08/19/2023] [Indexed: 10/10/2023] Open
Abstract
Abstract Background Although optical internal urethrotomy is popular among the urologists due to its simplicity and safety, urethroplasty is considered the gold standard treatment for urethral strictures. This study aims to determine the 1-year recurrence rate of urethral strictures after optical urethrotomy and identify predictors of recurrence in a tertiary center in Ethiopia. Methods A prospective observational cohort study was conducted on 80 male patients who underwent optical urethrotomy from November 2019 to August 2020 in a tertiary center in Ethiopia. Logistic regression was used to analyze the association between dependent and independent variables, with a P-value of <0.05 considered statistically significant. Results The mean and median age (±SD) of patients at the time of the procedure were 54.76 (±14.74) and 58 years with a range [20-78], respectively. Urethral discharge was the most common etiology identified in 39 (48.75%) of patients. Eleven (13.75%) patients had no identifiable etiology for their urethral stricture disease.The majority of patients presented with at least one voiding lower urinary tract symptoms.Sixty-eight (85%) patients out of the total had a single stricture and 12 (15%) had multiple strictures. The location of the stricture was in the bulbar urethra on cystourethrography in 83% of the patients. The 1-year recurrence rate of urethral stricture after optical urethrotomy was 35% in our study.The number of strictures and the presence of hypertension were independent predictors of recurrence of urethral stricture within 1-year after treatment with optical urethrotomy (AOR=15.35, 95% CI: 2.92-80.61, P=0.00; AOR=19.47, 95% CI: 2.11-178.98, P=0.01, respectively). Conclusions Our study identified that multiple strictures, and the presence of hypertension are associated with an increased recurrence rate in the first postoperative year.
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Affiliation(s)
- Feysel H. Issack
- Department of Surgery, St Paul’s Hospital Millennium Medical College, Swaziland Street, Addis Ababa, Ethiopia
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Jhanwar A, Sokhal AK, Singh K, Sankhwar S, Saini DK. Assessment of quality of life in patients of urethral stricture on clean intermittent catheterization following direct vision internal urethrotomy. Urol Ann 2018; 10:395-399. [PMID: 30386093 PMCID: PMC6194795 DOI: 10.4103/ua.ua_34_17] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Context: Clean intermittent catheterization (CIC) after direct vision internal urethrotomy (DVIU) Aims: The aim is to assess the quality of life (QOL) in patients with urethral strictures on CIC following DVIU. Settings and Design: Prospective study. Materials and Methods: This prospective study was conducted between August 2013 and July 2015 in the Department of Urology at KGMU, Lucknow. We included patients above the age of 18 years with stricture urethra, who were on CIC following direct visual internal urethrotomy. Patients below the age of 18 years, noncompliance, concomitant neurogenic voiding dysfunction, multiple strictures, pan anterior strictures, and posterior stenosis were excluded from the study. A 16 French Foley catheter was used for CIC following DVIU. Patients were evaluated at follow-up visit at 3, 6, and 12 months. At each follow-up visits, patients were assessed using CIC-QOL questionnaire, maximum urine flow rate and complications related to CIC if any. Statistical Analysis Used: Unpaired t-test was used to compare continuous data, and Fisher's exact test was used to analyze categorical data. Results: Among total 144 male patients evaluated, we included 97 patients, who underwent DVIU. Mean age of the study population was 37.7 ± 14.03 years. Most urethral strictures were idiopathic (64.02%) followed by postinflammatory (24.25%). A significant number of patients reported difficulty in performing CIC, which hampered daily activities. No major procedure related complications were reported. Patients who were compliant to CIC reported no stricture recurrence till 6 months follow-up. Conclusions: CIC following DVIU remains a reasonable adjunctive option. All the parameters of CIC-QOL questionnaire had improved on continuing CIC. Young men on CIC had greater impairment of QOL when compared to aged patients.
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Affiliation(s)
- Ankur Jhanwar
- Department of Urology, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Ashok Kumar Sokhal
- Department of Urology, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Kawaljit Singh
- Department of Urology, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Satyanarayan Sankhwar
- Department of Urology, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Durgesh Kumar Saini
- Department of Urology, King George's Medical University, Lucknow, Uttar Pradesh, India
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Beckley I, Garthwaite M. Post-operative care following primary optical urethrotomy: towards an evidence based approach. JOURNAL OF CLINICAL UROLOGY 2012. [DOI: 10.1016/j.bjmsu.2012.04.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Introduction: Optical urethrotomy (OU) is the commonest procedure performed for primary bulbar urethral strictures. Recurrence rates of up to 50% are reported, but data is lacking on the influence of post-operative management regimes on patient’s outcomes. The aim of this study was to quantify the variation in treatment approaches within a region and determine from the literature what constitutes best practice. Methods: A survey regarding post-operative management following OU was sent to urologists in the Yorkshire Deanery. The questions related to post-operative catheter usage, intermittent self dilatation (ISD) regimes and follow-up investigations. A literature review regarding these aspects of post-operative care was subsequently performed. Results: Questionnaires were sent to 70 urologists, of which 42 urologists replied. All respondents insert a urethral catheter following OU. Two thirds of respondents advise patients to perform ISD but one third of those advise continuing for only 6 months. Uroflowmetry and post micturition residual estimation are the mainstay of follow up investigations. Conclusions: The practice in our region largely reflects the best available evidence. The literature suggests that catheter size/material has no effect on outcome. Catheter duration should be for less than 3 days due to increased risk of recurrence. ISD should be performed for at least one year as this is associated with significantly lower recurrence rates than 6 months treatment. Urethrography is more accurate than uroflowmetery for follow up but results must be correlated with patient symptoms.
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Affiliation(s)
- Ian Beckley
- Department of Urology, Castle Hill Hospital, Cottingham, Yorkshire, UK
| | - Mary Garthwaite
- Department of Urology, Castle Hill Hospital, Cottingham, Yorkshire, UK
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Sallami S, Mouine Y, Rhouma SB, Cherif K, Dahmani A, Horchani A. Clean Intermittent Catheterization Following Urethral Stricture Surgery Using a Low Friction Catheter Versus Conventional Plastic Catheter: A Prospective, Randomized Trial. ACTA ACUST UNITED AC 2011. [DOI: 10.3834/uij.1944-5784.2011.02.07] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Sallami S, Mouine Y, Rhouma SB, Cherif K, Dahmani A, Horchani A. Clean Intermittent Catheterization Following Urethral Stricture Surgery Using a Low Friction Catheter Versus Conventional Plastic Catheter: A Prospective, Randomized Trial. ACTA ACUST UNITED AC 2011. [DOI: 10.3834/uij.1944-5784.2011.04.07] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Delai F, Ziming W, Tie C, Hecheng L, Huibo Z, Peng Z, Weimin G. Development and characterization of urethral stricture model in rabbits. ACTA ACUST UNITED AC 2010. [DOI: 10.1016/s1000-1948(11)60004-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Kishore TA, Bhat S, John RP. Colour Doppler ultrasonographic location of the bulbourethral artery, and its impact on surgical outcome. BJU Int 2005; 96:624-8. [PMID: 16104922 DOI: 10.1111/j.1464-410x.2005.05696.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To assess the location of bulbourethral arteries in men with a 'normal' urethra and to study anatomical alterations in men with urethral stricture. PATIENTS AND METHODS A linear-array transducer was used on the ventral surface of the penis to study the urethra. Fifteen men with a normal urethra and 15 with a stricture of the bulbar urethra were assessed. After conventional grey-scale imaging to evaluate the extent of disease, the urethral artery in the bulbar urethra was located by colour Doppler ultrasonography. RESULTS The site of the urethral arteries in 'normal' men varied among individuals; they were at the 10-2 o'clock position in six men, 8-10 o'clock and 2-4 o'clock in six, and at the 4-8 o'clock position in three. In normal men the symmetry of arteries was maintained and the mean distance from the lumen was 2.67 mm. In men with urethral stricture, there was a loss of symmetry in all cases. In a dense stricture the urethral arteries could not be detected on either side in three of cases, while only a single artery was seen in three. In two men, both the arteries were on one side. The mean distance of the urethral artery from the lumen of urethra was 1.88 mm. CONCLUSIONS Contrary to the popular belief that the urethral arteries are located at the 3 and 9 o'clock position, we found that there was no predictable pattern for their anatomy. These observations might have implications for treating urethral stricture disease with visual internal urethrotomy, as they could help to avoid injury to the bulbourethral artery.
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Andersen HL, Duch BU, Gregersen H, Nielsen JB, Ørskov H. The effect of the somatostatin analogue lanreotide on the prevention of urethral strictures in a rabbit model. UROLOGICAL RESEARCH 2003; 31:25-31. [PMID: 12624660 DOI: 10.1007/s00240-003-0296-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2002] [Accepted: 12/18/2002] [Indexed: 10/25/2022]
Abstract
We evaluated the effect of the somatostatin analogue lanreotide on the development of surgically induced experimental strictures in the anterior urethra of the male rabbit. A total of 74 male rabbits were randomly allocated into four groups. Lanreotide was administered to the rabbits in groups 2 and 4 from day 0 to 14. To create a stricture, a resection was made in the urethra of the rabbits in groups 3 and 4 on day 2. On day 30, all rabbits were examined with urethrography, impedance planimetry and either histology or for collagen content. Urethrography and impedance planimetry demonstrated a urethral stricture in all operated animals. No difference was found between the two stricture groups, regardless of lanreotide administration, with respect to luminal cross-sectional area (CSA), circumferential tension-strain relation, histology or collagen content. The CSA of the urethra of the normal controls treated with lanreotide was smaller than the CSA of the normal controls not treated with lanreotide, however, no difference was found in histology or collagen content. Lanreotide had no measurable effect on the development of a surgically induced stricture in the male rabbit anterior urethra, however, lanreotide seems to exert an inhibitory effect on the normal growth of the urethra.
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Affiliation(s)
- H L Andersen
- Institute of Experimental Clinical Research, University of Aarhus, Aarhus, Denmark.
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Gnanaraj J, Devasia A, Gnanaraj L, Pandey AP. Intermittent self catheterization versus regular outpatient dilatation in urethral stricture: a comparison. THE AUSTRALIAN AND NEW ZEALAND JOURNAL OF SURGERY 1999; 69:41-3. [PMID: 9932920 DOI: 10.1046/j.1440-1622.1999.01490.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND The results of regular intermittent self catheterization were compared with regular outpatient dilatation after endoscopic internal urethrotomy for urethral strictures. METHODS The records of patients who were treated for urethral stricture disease over a 4-year period from 1991 to 1994 were reviewed. They were either on regular urethral dilatation or were advised to carry out self calibration. A follow-up questionnaire was sent to them and they were asked to attend a review. Student's t-test and Proportion Test were used to find out if there was any significant difference between the two groups. RESULTS There were 78 patients who were on self calibration and 49 patients on regular urethral dilatation. There was no significant difference between the two groups regarding the duration of follow-up (21.5 and 23.7 months, respectively); the length of stricture (1.5 and 1.7 cm, respectively); and complications (two and four, respectively). However, patients on self calibration had narrower strictures (4.8 and 5.7 F) and a significantly lower restricture rate (5 and 16%). The current urinary stream was compared to the immediate postoperative stream. This showed that a higher number of patients in the dilatation group were voiding at less than 25% of their immediate postoperative flow. People from high and low socio-economic groups were able to carry out self calibration satisfactorily. CONCLUSION Patients from high and low socio-economic groups found that self calibration resulted in a lower restricture rate and better stream when compared to regular urethral dilatation.
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Affiliation(s)
- J Gnanaraj
- Department of Urology, Christian Medical College and Hospital, Vellore, India.
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Giannakopoulos X, Grammeniatis E, Gartzios A, Tsoumanis P, Kammenos A. Sachse urethrotomy versus endoscopic urethrotomy plus transurethral resection of the fibrous callus (Guillemin's technique) in the treatment of urethral stricture. Urology 1997; 49:243-7. [PMID: 9037288 DOI: 10.1016/s0090-4295(96)00450-5] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVES Advances in endoscopic instrumentation and technique have expanded the urologist's armamentarium for effective and safe treatment of urethral strictures. This prospective study included 80 patients who presented with single, iatrogenic, annular strictures of the bulbar urethra. The length of the stricture was 1 to 2 cm, with an average of 1.5 cm. METHODS Patients were randomly divided into two groups: group A, 40 patients who underwent direct-optical endoscopic urethrotomy with a guide catheter via cold-knife incision at the 12 o'clock position (Sachse urethrotomy), and group B, 40 patients who underwent double direct-optical endoscopic urethrotomy with a guide catheter via cold-knife incisions at the 11 and 1 o'clock positions, followed by transurethral resection of all scar tissues (Guillemin's technique). The results obtained were analyzed and compared at 6 months, 12 months, 24 months, 3 years, and 5 years postoperatively by clinical evaluation, uroflowmetry, and retrograde and voiding urethrographies. RESULTS Group A obtained 95% good results at 6 months, 85% at 12 months, 55% at 24 months, 45% at 3 years, and 25% at 5 years. Group B obtained 98% good results at 6 months, 95% at 12 months, 90% at 24 months, 80% at 3 years, and 70% at 5 years. CONCLUSIONS The differences between the two groups are not significant at 6 and 12 months (P > 0.05). They are statistically significant after 24 months, 3 years, and 5 years (P < 0.05).
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Affiliation(s)
- X Giannakopoulos
- Department of Urology, Ioannina University School of Medicine, University Hospital, Greece
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12
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Chiou RK, Anderson JC, Tran T, Patterson RH, Wobig R, Taylor RJ. Evaluation of urethral strictures and associated abnormalities using high-resolution and color Doppler ultrasound. Urology 1996; 47:102-7. [PMID: 8560640 DOI: 10.1016/s0090-4295(99)80391-4] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
OBJECTIVES To study the role of urethral sonography and color Doppler imaging in the evaluation of patients with urethral strictures and associated abnormalities. METHODS We reviewed our experience with 41 urethral sonographic studies in 35 patients and compared them to 33 retrograde urethrograms. For 6 recent cases, we also used color Doppler imaging to assess spongiosal tissue blood flow and the location of urethral arteries. RESULTS Both retrograde urethrography and urethral sonography assessed the caliber and length of the strictures well. Urethral sonography provided additional information about stricture involvement of the spongiosum, location of urethral arteries, and associated abnormalities (that is, periurethral abscess and urethrocutaneous fistula). This information was useful for the clinical stratification of urethral stricture disease and the planning of treatment. CONCLUSIONS With the advantages of avoiding radiation to testis, providing real-time evaluation of the distensibility of the urethra, and having the capacity of assessing spongiosum and periurethral tissue involvement and urethral artery location, urethral sonography appears to offer more than retrograde urethrography for the evaluation of anterior urethral stricture.
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Affiliation(s)
- R K Chiou
- Urology Section, Omaha Veterans Affairs Medical Center, Nebraska, USA
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Ishigooka M, Tomaru M, Hashimoto T, Sasagawa I, Nakada T, Mitobe K. Recurrence of urethral stricture after single internal urethrotomy. Int Urol Nephrol 1995; 27:101-6. [PMID: 7615362 DOI: 10.1007/bf02575227] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Recurrence of urethral stricture after single internal urethrotomy was investigated in 66 patients with special reference to some factors which would influence restricturing. In the present study, recurrence rate was 16.7% (11 patients). Recurrences occurred within an average of 11.9 months. Factors that had no influence on restricturing were age, aetiology, site of the stricture and duration of indwelling catheterization. On the other hand, stricture length appeared to influence the outcome (chi 2, p < 0.001). Short stricture (< or = 10 mm) showed only 4.4% recurrence rate, while 42.9% in long stricture (> 10 mm). Internal urethrotomy appeared to be effective particularly when the stricture was short, while it seemed difficult to treat long strictures by single internal urethrotomy.
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Affiliation(s)
- M Ishigooka
- Department of Urology, Yamagata University, School of Medicine, Japan
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Harriss DR, Beckingham IJ, Lemberger RJ, Lawrence WT. Long-term results of intermittent low-friction self-catheterization in patients with recurrent urethral strictures. BRITISH JOURNAL OF UROLOGY 1994; 74:790-2. [PMID: 7827853 DOI: 10.1111/j.1464-410x.1994.tb07127.x] [Citation(s) in RCA: 49] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
OBJECTIVE To ascertain the duration of intermittent low-friction self-catheterization (ILSC) required to cause stricture stabilization. PATIENTS AND METHODS Over a 4 year period, 101 patients with a median age of 62 years (range 16-85) with recurrent urethral strictures were recruited to the trial. All the strictures were treated by internal urethrotomy and the patients were then randomized to perform ILSC twice weekly for either 6 months (group 1) or 36 months (group 2). Out-patient follow-up with urinary flow rate was initially at 1 month and then at 3 monthly intervals. Stricture recurrence rates were compared between the two groups. RESULTS Of 101 patients, seven failed to attend after the first out-patient appointment. A further 21 died of unrelated disease whilst on ILSC (although 13 had been followed up for at least 24 months and so were included in the analysis). The median follow-up was 67 months (range 24-78). Ten patients in group 2, who had suffered from recurrent strictures, refused to stop catheterizing at the appointed time and all remain stricture-free on permanent ILSC. Of the remaining 76 patients, 48 catheterized for 6 months and 28 patients performed ILSC for 12 to 36 months (nine stopped earlier than intended). Forty per cent of patients who stopped at 6 months developed a recurrence compared with 14% who catheterized for more than 12 months (P < 0.05) (chi-square test with Yates' correction). CONCLUSIONS Our results indicate that ILSC is safe and effective in preventing stricture recurrence in the long term. The recurrence rate of urethral strictures was significantly lower when ILSC was continued for more than 12 months compared with ILSC that was stopped at 6 months. We conclude that catheterization for at least 1 year is required to achieve adequate urethral stabilization.
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Affiliation(s)
- D R Harriss
- Department of Urology, City Hospital Trust, Nottingham, UK
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Kjaergaard B, Walter S, Bartholin J, Andersen JT, Nøhr S, Beck H, Jensen BN, Lokdam A, Glavind K. Prevention of urethral stricture recurrence using clean intermittent self-catheterization. BRITISH JOURNAL OF UROLOGY 1994; 73:692-5. [PMID: 8032838 DOI: 10.1111/j.1464-410x.1994.tb07558.x] [Citation(s) in RCA: 48] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
OBJECTIVE To investigate the effect of clean intermittent catheterization (CIC) on prevention of urethral stricture recurrence after internal urethrotomy. PATIENTS AND METHODS Of 55 men who were randomly selected, 43 completed the investigation. Of these, 21 patients performed CIC weekly for 1 year following Sachse's operation for urethral stricture and 22 patients formed the control group after the same operation. All had an objective examination for urethral stricture every 2 months after surgery. RESULTS Significantly fewer (P < 0.01) patients developed recurrence of urethral stricture within the first postoperative year in the CIC group (n = 4) compared with the control group (n = 15). No CIC complications were seen, and patients who completed the CIC programme considered the method fully acceptable. CONCLUSION Weekly CIC is a simple method of reducing the frequency of urethral stricture recurrence after internal urethrotomy.
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Affiliation(s)
- B Kjaergaard
- Department of Urology, Aalborg Hospital, Denmark
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Newman LH, Stone NN, Chircus JH, Kramer HC. Recurrent urethral stricture disease managed by clean intermittent self-catheterization. J Urol 1990; 144:1142-3. [PMID: 2231886 DOI: 10.1016/s0022-5347(17)39676-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
We studied 41 patients with urethral stricture who had failed at least 1 operation, and were being maintained with filiform and follower dilation every 6 to 12 weeks. The patients were instructed in clean intermittent self-catheterization with a 16F red rubber catheter, which was performed every 1 to 30 days. Followup from 9 to 36 months revealed excellent compliance and average peak uroflow rates increased from 5.5 cc per second before dilation to 17.1 cc per second at the last followup visit. Clean intermittent self-catheterization is a simple method to maintain a patent urethra and obviates the need for further operations or painful dilations.
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Affiliation(s)
- L H Newman
- Department of Urology, Elmhurst Hospital Center, New York, New York
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Mohanty NK, Kachroo SL. Optical internal urethrotomy as the treatment of choice for primary stricture of the urethra. BRITISH JOURNAL OF UROLOGY 1988; 62:261-2. [PMID: 3191341 DOI: 10.1111/j.1464-410x.1988.tb04330.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Seventy-five patients with primary urethral strictures were treated by optical urethrotomy with catheter drainage for 7 days. Good results were obtained in 66% of cases, which were all post-traumatic in nature; 34% had to undergo further procedures such as dilatation or repeat internal urethrotomy.
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Affiliation(s)
- N K Mohanty
- Department of Urology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, India
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Abstract
The physical characteristics of the argon laser wavelength allow a precise incision with excellent hemostasis and negligible heating of adjacent tissues resulting in less scarring. These qualities are used to advantage in the treatment of strictures. The argon laser was used to perform 13 internal urethrotomies and ten vesical neck incisions. The operative method used is similar to optical internal urethrotomy. The argon probe incises hemostatically, reducing the need for extensive fulguration of tissues at the operative site and thereby reducing the tendency for more scar tissue to form and compromise the operation. The same hemostasis reduces the need for postoperative indwelling urethral catheterization. Utility of the argon device in most instances allows treatment to be conducted on an outpatient basis without general anesthesia and without use of postoperative urethral catheters, yielding an effective, cost-saving therapy.
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Affiliation(s)
- W C Adkins
- Department of Urology, Saint Vincent Health Center, Erie, PA 16544
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