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Journal articles on the topic 'Urethrotomy'

Author: Grafiati

Published: 4 June 2021

Last updated: 1 February 2022

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1

Debnath, Ripan, Md Nabid Alam, Md Towhid Belal, Prodyut Kumar Saha, Uttam Karmaker, and Md Shafiqul Alam Chowdhury. "Outcome of Laser Urethrotomy in Comparison with Optical Internal Urethrotomy in Recurrent Stricture Urethra Following Perineal Anastomotic Urethroplasty for PUDD." Bangladesh Journal of Urology 23, no. 2 (November 15, 2020): 181–87. http://dx.doi.org/10.3329/bju.v23i2.50312.

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Objective: To compare the outcome of laser urethrotomy and optical internal urethrotomy(OIU) for the treatment of recurrent stricture urethra following perineal anastomotic urethroplasty for posterior urethral distraction defect. Materials and methods: The study was conducted in Dhaka Medical College Hospital from January 2013 to December 2014.Male patients presented with obstructed voiding symptoms following perineal anastomotic urethroplasty were evaluated by their history, physical findings and investigations (urinalysis, uroflowmetry, retrograde urethrogram and micturiting cystourethrogram ) & primarily 64 patients are selected by purposive sampling. Patients are divieded again by random allocation into group A and group B and underwent for OIU and laser urethrotomy respectively. Results: Comparison was made to find out the better method between optical urethrotomy and laser urethrotomy. Overall per-operative complications (bleeding, extravasations of irrigating fluid, false passage and broken knife) in the former group were 31.3% compared to none in the latter group. Post-operative complications like bleeding, haematoma, penile oedema and erectile dysfunction were found only in Group-A (p=0.002). The mean duration of postoperative catheterization and average hospital stay were observed to be much higher in Group-A than that in Group-B (p=0.000008; p=0.0006). Comparison of final outcome (development of stricture) between groups at 1 year of evaluation in Group-A and Group-B was not significant (p= 0.320). Conclusion: Laser urethrotomy is better than optical urethrotmy in regards of peroperative and post-operative complications. Bangladesh Journal of Urology, Vol. 23, No. 2, July 2020 p.181-187

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2

Pansadoro, V., and P. Emiliozzi. "Internal urethrotomy." Der Urologe 37, no. 1 (January 1998): 21–24. http://dx.doi.org/10.1007/s001200050143.

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3

Hyn, Choe Sung, Kim Han Jong, and Choe Un Chol. "A report on the clinical efficacy of a new Bougie-internal urethrectomy." Canadian Urological Association Journal 9, no. 7-8 (July 17, 2015): 447. http://dx.doi.org/10.5489/cuaj.2751.

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Introduction: We compare the clinical efficacy of the new bougieinternal urethrectomy (BIU) with internal urethrotomy and urethroplasty to treat urethral stricture disease. Methods: We prospectively studied 186 people with urethral stricture disease. Of these, 84 were identified for urethroplasty and 102 for internal urethrotomy (endoscopic urethrotomy). Among the 84 identified for urethroplasty, 52 received BIU (Group 1) and the remaining 32 received urethroplasty. Among the 102 identified for internal urethrotomy, 58 received BIU (Group 2) and the remaining 44 received the internal urethrotomy. After surgery, we evaluated the clinical efficacy of the BIU (operative invasions, voiding flow rates, complications, sequelae) compared with the endoscopic treatment and urethroplasty.Results: Patient age ranged from 20 to 70 years. The follow-up period was 2 years. In the BIU Group 1, the BIU Group 2, and the internal urethrotomy (endoscopic treatment), the length of strictures were 2.9 ± 1.5, 2.8 ± 1.3, 1.6 ± 0.7, and 1.5 ± 0.6, respectively. In the BIU Group 1, the urethroplasty, the BIU Group 2, and the internal urethrotomy (endoscopic treatment), the amount of bleeding was 34.1 ± 17.1, 172.2 ± 29.8, 28.5 ± 9.8, and 49.7 ± 13.6 mL, respectively. In the BIU Group 1, the urethroplasty, the BIU Group 2, and the internal urethrotomy, the recurrence rates were 5.8%, 86%, 6.8% and 25%, and the average flow rates were 18.1 ± 4.8, 13.1 ± 3.9, 18.2 ± 3.6, 10.1 ± 3.1 mL/s, respectively. There was no sequealae (sexual dysfunction, penile change) in both BIU groups.Conclusions: The new BIU could be considered first-line treatment in all patients with indications for visual internal urethrotomy and urethroplasty.

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Stamatiou, Konstantinos, Aggeliki Papadatou, Hippocrates Moschouris, Ioannis Kornezos, Anargiros Pavlis, and Georgios Christopoulos. "A Simple Technique to Facilitate Treatment of Urethral Strictures with Optical Internal Urethrotomy." Case Reports in Urology 2014 (2014): 1–3. http://dx.doi.org/10.1155/2014/137605.

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Urethral stricture is a common condition that can lead to serious complications such as urinary infections and renal insufficiency secondary to urinary retention. Treatment options include catheterization, urethroplasty, endoscopic internal urethrotomy, and dilation. Optical internal urethrotomy offers faster recovery, minimal scarring, and less risk of infection, although recurrence is possible. However, technical difficulties associated with poor visualization of the stenosis or of the urethral lumen may increase procedural time and substantially increase the failure rates of internal urethrotomy. In this report we describe a technique for urethral catheterization via a suprapubic, percutaneous approach through the urinary bladder in order to facilitate endoscopic internal urethrotomy.

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Cavalcanti, André G., and Gustavo Fiedler. "Opinion: Endoscopic Urethrotomy." International braz j urol 41, no. 4 (August 2015): 619–22. http://dx.doi.org/10.1590/s1677-5538.ibju.2015.04.03.

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6

Kesner, K. M. "Catheterization postoptical urethrotomy." Urology 27, no. 6 (June 1986): 575. http://dx.doi.org/10.1016/0090-4295(86)90353-5.

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7

Tinaut-Ranera, Javier, Miguel Angel Arrabal-Polo, Sergio Merino-Salas, Mercedes Nogueras-Ocaña, Victor Lopez-Leon, Francisco Palao-Yago, Miguel Arrabal-Martin, Clara Lahoz-Garcia, Miguel Alaminos, and Armando Zuluaga-Gomez. "Outcome of urethral strictures treated by endoscopic urethrotomy and urethroplasty." Canadian Urological Association Journal 8, no. 1-2 (January 14, 2014): 16. http://dx.doi.org/10.5489/cuaj.1407.

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Introduction: We analyze the outcomes of patients with urethral stricture who underwent surgical treatment within the past 5 years.Methods: This is a retrospective study of male patients who underwent surgery for urethral stricture at our service from January 2008 to June 2012. We analyzed the comorbidities, type, length and location of the stricture and the surgical treatment outcome after endoscopic urethrotomy, urethroplasty or both.Results: In total, 45 patients with a mean age of 53.7 ± 16.7 years underwent surgical treatment for urethral stricture. Six months after surgery, 46.7% of the patients had a maximum urinary flow greater than 15 mL/s, whereas 87.3% of the patients exhibited no stricture by urethrography after the treatment. The success rate in the patients undergoing urethrotomy was 47.8% versus 86.4% in those undergoing urethroplasty (p = 0.01). Twenty percent of the patients in whom the initial urethrotomy had failed subsequently underwent urethroplasty, thereby increasing the treatment success.Conclusion: In most cases, the treatment of choice for urethral stricture should be urethroplasty. Previous treatment with urethrotomy does not appear to produce adverse effects that affect the outcome of a urethroplasty if urethrotomy failed, so urethrotomy may be indicated in patients with short strictures or in patients at high surgical risk.

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Pahwa, Mrinal, Sanjeev Gupta, Mayank Pahwa, Brig D. K. Jain, and Manu Gupta. "A Comparative Study of Dorsal Buccal Mucosa Graft Substitution Urethroplasty by Dorsal Urethrotomy Approach versus Ventral Sagittal Urethrotomy Approach." Advances in Urology 2013 (2013): 1–5. http://dx.doi.org/10.1155/2013/124836.

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Objectives. To compare the outcome of dorsal buccal mucosal graft (BMG) substitution urethroplasty by dorsal urethrotomy approach with ventral urethrotomy approach in management of stricture urethra.Methods and Materials. A total of 40 patients who underwent dorsal BMG substitution urethroplasty were randomized into two groups. 20 patients underwent dorsal onlay BMG urethroplasty as described by Barbagli, and the other 20 patients underwent dorsal BMG urethroplasty by ventral urethrotomy as described by Asopa. Operative time, success rate, satisfaction rate, and complications were compared between the two groups. Mean follow-up was 12 months (6–24 months).Results. Ventral urethrotomy group had considerably lesser operative time although the difference was not statistically significant. Patients in dorsal group had mean maximum flow rate of 19.6 mL/min and mean residual urine of 27 mL, whereas ventral group had a mean maximum flow rate of 18.8 and residual urine of 32 mL. Eighteen out of twenty patients voided well in each group, and postoperative imaging study in these patients showed a good lumen with no evidence of leak or extravasation.Conclusion. Though ventral sagittal urethrotomy preserves the blood supply of urethra and intraoperative time was less than dorsal urethrotomy technique, there was no statistically significant difference in final outcome using either technique.

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Danilov, S. P., R. B. Sukhanov, E. A. Bezrukov, D. V. Enikeev, D. V. Butnaru, N. I. Sorokin, A. M. Dymov, and D. S. Davydov. "Thulium laser urethrotomy and optical urethrotomy in short urethral strictures." Urology and Andrology 6, no. 2 (2018): 40–44. http://dx.doi.org/10.20953/2307-6631-2018-2-40-44.

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Naser, Md Fazal, Md Abul Hossain, Shafiqul Azam, Ahmed Saiful Jabbar, and Md Shohrab Hossain. "Optical Internal Urethrotomy for Urethral Stricture Under a New Local Anaesthesia Technique." Bangladesh Journal of Urology 17, no. 2 (September 15, 2020): 64–66. http://dx.doi.org/10.3329/bju.v17i2.49152.

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Objectives: To determine the feasibility of routinely performing internal optical urethrotomy for anterior urethral stricture under intracorpus spongiosum anesthesia in an outpatient setting. Methods. In this prospective study a consecutive series of 34 patients with anterior urethral stricture, a dosage of 3 mL of 1% lidocaine was slowly injected into the glans penis. Next, optical urethrotomy was performed immediately with a cold-cutting knife. The effect of this anesthetic technique was evaluated by questionnaire. Results. Internal urethrotomy was successfully completed in all the patients. Thirty-two patients (94.12%) had no pain or discomfort. Two patient reported minimal but tolerable discomfort while the tissue above the stricture was being cut. The anesthesia lasted for about 1.5 hours and was very satisfactory without any complications. Conclusions. Under intracorpus spongiosum anesthesia, optical urethrotomy can be routinely performed in an outpatient setting. With this new local anesthesia, internal urethrotomy is a safe, effective, simple, and inexpensive procedure for treatment of anterior urethral stricture. Bangladesh Journal of Urology, Vol. 17, No. 2, July 2014 p.64-66

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Irdam, Gampo Alam, Irfan Wahyudi, and Andy Andy. "Efficacy of mitomycin-C on anterior urethral stricture after internal urethrotomy: A systematic review and meta-analysis." F1000Research 8 (August 8, 2019): 1390. http://dx.doi.org/10.12688/f1000research.19704.1.

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Background: Mitomycin-C is an agent that plays an important role in the tissue healing process and scar formation. This study aims to investigate the efficacy of mitomycin-C in treating anterior urethral stricture following internal urethrotomy. Methods: Studies evaluating the efficacy of mitomycin-c for anterior urethral stricture post urethrotomy were searched using PubMed, Scopus, ScienceDirect, EBSCOHost, Cochrane Reviews, and OVID as directory databases. Terms used in the searching process were “mitomycin-c” or “mitomycin”, “urethral stricture”, “urethral stenosis”, “internal urethrotomy”, “optical urethrotomy” and its synonyms. Every randomized controlled trial study conducted in human subjects was included. Study appraisals were conducted in accordance with Oxford University Center for Evidence-Based Medicine guidelines. The conclusion of each study was summarized and the calculation of fixed effect from every study was conducted in meta-analysis. Results: Included in this study were three studies involving 231 patients. All of them reported less recurrence of in patients treated with mitomycin-c post urethrotomy (p<0.001). The fixed risk ratio of all studies was 0.32 with 95% confidence interval (0.19-0.54). All studies also reported less stricture length after treatment with mitomycin-c, but there were not statistical differences between with or without treatment group. Conclusion: Mitomycin-C has efficacy in treating anterior urethral stricture after internal urethrotomy. However, the inclusion of relatively few studies may affect the strength of this review and further studies need to be done.

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Irdam, Gampo Alam, Irfan Wahyudi, and Andy Andy. "Efficacy of mitomycin-C on anterior urethral stricture after internal urethrotomy: A systematic review and meta-analysis." F1000Research 8 (June 3, 2020): 1390. http://dx.doi.org/10.12688/f1000research.19704.2.

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Background and Aim Mitomycin-C is a potent agent that plays an important role in tissue healing and scar formation. This study aims to investigate the efficacy of Mitomycin-C in treating anterior urethral stricture after internal urethrotomy. Methods Studies evaluating efficacy of mitomycin-c for anterior urethral stricture post urethrotomy were searched using Pubmed, Scopus, Sciencedirect, MEDLINE, and Cochrane Reviews as directory databases. The search was done in March 15th 2020. Terms being used in the searching process were “mitomycin-c” or “mitomycin”, “urethral stricture”, “urethral stenosis”, “internal urethrotomy”, “optical urethrotomy” and its synonyms. Every study with the design of retrospective or prospective clinical study being done in human subject was included. Study appraisal conducted in accordance to Oxford University Center for Evidence-Based Medicine. The conclusion of each study was summarized and the calculation of random effect from every study was conducted in meta-analysis. Random effect model is chosen because small number of studies and quite different. Results Three studies involving 311patients were included in this review, all of them reported less recurrence of in patients treated with mitomycin-c post urethrotomy (p<0.001). Risk ratio of all studies was 0.41 with 95% confidence interval (0.25-0.68). Conclusion Mitomycin-C has the potential of efficacy in treating anterior urethral stricture post internal urethrotomy. Relatively few numbers of studies may impact in the strength of this review and further studies need to be done.

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Irdam, Gampo Alam, Irfan Wahyudi, and Andy Andy. "Efficacy of mitomycin-C on anterior urethral stricture after internal urethrotomy: A systematic review and meta-analysis." F1000Research 8 (August 10, 2020): 1390. http://dx.doi.org/10.12688/f1000research.19704.3.

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Background and Aim Mitomycin-C is a potent agent that plays an important role in tissue healing and scar formation. This study aims to investigate the efficacy of Mitomycin-C in treating anterior urethral stricture after internal urethrotomy. Methods Studies evaluating efficacy of mitomycin-c for anterior urethral stricture post urethrotomy were searched using Pubmed, Scopus, Sciencedirect, MEDLINE, and Cochrane Reviews as directory databases. The search was done in March 15th 2020. Terms being used in the searching process were “mitomycin-c” or “mitomycin”, “urethral stricture”, “urethral stenosis”, “internal urethrotomy”, “optical urethrotomy” and its synonyms. Every study with the design of retrospective or prospective clinical study being done in human subject was included. Study appraisal conducted in accordance to Oxford University Center for Evidence-Based Medicine. The conclusion of each study was summarized and the calculation of random effects from every study was conducted in meta-analysis. Random effects model is chosen because small number of studies and quite different. Results Three studies involving 311patients were included in this review, all of them reported less recurrence of in patients treated with mitomycin-c post urethrotomy (p<0.001). Risk ratio of all studies was 0.41 with 95% confidence interval (0.25-0.68). Conclusion Mitomycin-C has the potential of efficacy in treating anterior urethral stricture post internal urethrotomy. Relatively few numbers of studies may impact in the strength of this review and further studies need to be done.

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Al Taweel, Waleed, and Raouf Seyam. "Visual Internal Urethrotomy for Adult Male Urethral Stricture Has Poor Long-Term Results." Advances in Urology 2015 (2015): 1–4. http://dx.doi.org/10.1155/2015/656459.

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Objective. To determine the long-term stricture-free rate after visual internal urethrotomy following initial and follow-up urethrotomies.Methods. The records of all male patients who underwent direct visual internal urethrotomy for urethral stricture disease in our hospital between July 2004 and May 2012 were reviewed. The Kaplan-Meier method was used to analyze stricture-free probability after the first, second, third, fourth, and fifth urethrotomies.Results. A total of 301 patients were included. The overall stricture-free rate at the 36-month follow-up was 8.3% with a median time to recurrence of 10 months (95% CI of 9.5 to 10.5, range: 2–36). The stricture-free rate after one urethrotomy was 12.1% with a median time to recurrence of eight months (95% CI of 7.1–8.9). After the second urethrotomy, the stricture-free rate was 7.9% with a median time to recurrence of 10 months (95% CI of 9.3 to 10.6). After the third to fifth procedures, the stricture-free rate was 0%. There was no significant difference in the stricture-free rate between single and multiple procedures.Conclusion. The long-term stricture-free rate of visual internal urethrotomy is modest even after a single procedure.

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Regmi, Sunil, Sunil Chandra Adhikari, Saroj Yadav, Rabin Raj Singh, and Ravi Bastakoti. "Efficacy of Use of Triamcinolone Ointment for Clean Intermittent Self Catheterization following Internal Urethrotomy." Journal of Nepal Medical Association 56, no. 212 (August 31, 2018): 745–48. http://dx.doi.org/10.31729/jnma.3704.

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Introduction: Internal urethrotomy is recommended for the treatment of urethral strictures shorter than 1.5 cm but has been associated with high recurrence rates. The aim of this study was to evaluate the efficacy of use of triamcinolone ointment for clean intermittent self catheterization in the prevention of urethral stricture recurrence after internal urethrotomy. Methods: Total of 60 male patients undergoing internal urethrotomy were assigned into two groups and clean intermittent self catheterization was performed using either triamcinolone ointment or a water-based gel for lubrication of the catheter in this randomized clinical trial. Clean intermittent self catheterization regimen was continued for 6 months and patients were followed for 12 months. Urethrocystoscopic evaluation was done 6 and 12 months postoperatively. Results: The recurrence rates were compared between the two groups. There were no significant differences in patient characteristics and etiology of the stricture between the two groups. There was a 6 (22.22%) recurrence rate in the patients of the triamcinolone group against 13 (46.42%) in those of the control group after the first internal urethrotomy (P=0.04). After second internal urethrotomy, the urethra was stabilized in 5 (83.3%) of the patients in the triamcinolone group and 8 (61.5%) those in the control group (P=0.05). We also found a significant correlation between recurrence and stricture length (P=0.02) but the time to recurrence was not statistically significant (P=0.16). Conclusions: The use of triamcinolone ointment in patients on CISC regimen after internal urethrotomy significantly decreased the stricture recurrence rate.

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Azam, Asm Shafiul, Akm Kawsar Habib, Sm Mahbub Alam, Md Habibur Rahman, Md Abdus Salam, and Harun Or Rashid. "Comparative Study Of Optical Internal Urethrotomy Versus Anastomotic Urethroplasty For Short Segment Bulbar Urethral Stricture." Bangladesh Journal of Urology 16, no. 1 (March 11, 2020): 21–25. http://dx.doi.org/10.3329/bju.v16i1.45931.

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Objective: This study was conducted to compare the outcome of anastomotic urethroplasty with that of traditional optical internal urethrotomy in the treatment of short-segment bulbar urethral stricture. Methods: This comparative clinical study was conducted in the Department of Urology, Dhaka Medical College Hospital over a period 1 year from January 2007 to December 2008. A total of 50 patients with short-segment (< 2 cm) bulbar urethral strictures were consecutively included in the study. The test statistics used to analyses the data were Fisher’s Exact Probability Test, Student’s t-Test. For all analytical tests, the level of significance was set at 0.05 and p < 0.05 was considered significant. Results: About one-quarter (24%) of patients in OI Urethrotomy group experienced bleeding, 4% epididymitis and another 4% incontinence. In contrast, 8% of patients in Anastomotic Urethroplasty group complained of periurethral leakage, 8% fever and another 8% wound infection. Apart from bleeding, all the complications were almost homogeneously distributed between groups.Six (24%) of patients in OI Urethrotomy Group exhibited narrow urinary stream at month 3, as opposed to none in Anastomotic Urethroplasty Group (p = 0.001). Nearly 30% of patients in OI Urethrotomy Group had narrow urinary stream at month 6 compared 4% in Anastomotic Urethroplasty Group (p = 0.024). Of the 25 patients in OI Urethrotomy Group, 1(4%) developed UTI at month 3 and 5(20%) at month 6. None of the patients in Anastomotic Urethropasty Group developed UTI. There was significant difference between groups in terms of UTI at month 6 (p = 0.025).The recurrence rate of stricture in OI Urethrotomy was 24% (6 out of 25 patients) at month 3. However, none in Anastomotic Urethroplasty Group had history of recurrence of stricture (p = 0.011). At baseline the mean uroflowmetry was 5.5 ml/sec in both groups which immediately increased to 25.3 ± 2.6 ml/sec and 23.9 ± 2.2 ml/sec in OI urethrotomy and Anastomotic Urethroplasty groups respectively and then dropped to 18.4 ± 6.3 ml/sec and 20.2 ± 2.6 ml/sec in OI Urethrotomy and Anastomotic Urethroplasty groups respectively at month 3 and to 17.8 ± 6.4 ml/sec and 19.6 ± 2.6 ml/sec respectively at month 6. Conclusion: This study concludes that Anastomotic Urethroplasty is an effective and satisfactory technique for the treatment of short-segment bulbar urethral stricture. Bangladesh Journal of Urology, Vol. 16, No. 1, Jan 2013 p.21-25

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Kirchheim, Dieter, James A. Tremann, and Julian S. Ansell. "Transurethral urethrotomy under vision." Journal of Urology 167, no. 2 Part 2 (February 2002): 1097–100. http://dx.doi.org/10.1016/s0022-5347(02)80347-0.

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18

Roosen, Jens Ulrik. "Self-Catheterization after Urethrotomy." Urologia Internationalis 50, no. 2 (1993): 90–92. http://dx.doi.org/10.1159/000282459.

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Shrestha, Naresh Man. "A Comparative Study of patients, Undergoing Transurethral Resection of Prostate Gland With Or Without Otis Urethrotomy Before Surgery – A Single Institution Experience." Journal of Nepalgunj Medical College 14, no. 1 (June 13, 2017): 5–7. http://dx.doi.org/10.3126/jngmc.v14i1.17484.

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Background: Transurethral resection of prostate (TURP) is considered as the gold standard surgical treatment for Benign prostatic Hyperplasia (BPH). Among many post TURP complications, urethral stricture is one of the most dreaded urological complications, which may result in lifelong misery. The present study aimed to report the outcomes of Otis urethrotomy to prevent urethral stricture before TURP.Method: This was a comparative study between two equal groups of 100 patients who met inclusion criteria. Study conducted in the department of surgery, Urology unit, Nepalgunj Medical College from 2014 May to 2016 April. In group A, included all the patients underwent TURP without Otis urethrotomy and in group B , included all patients underwent TURP after doing Otis Urethrotomy. The patients were evaluated for evidence of urethral stricture formation.Result: In Group A, 20 patients out of 100(20%) developed urethral stricture whereas in Group B, 8 patients out of 100(8%) developed urethral stricture .The rate of Urethral Stricture in Group A is significantly more than in Group B (p<0.05).Conclusion: The incidence of urethral stricture formation can be significantly reduced by doing Otis urethrotomy before TURP than TURP alone.JNGMC Vol. 14 No. 1 July 2016, Page: 5-7

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Allen, Terry D. "Internal Urethrotomy in Female Subjects." Journal of Urology 136, no. 6 (December 1986): 1280. http://dx.doi.org/10.1016/s0022-5347(17)45312-2.

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JOHN, J., K. GEORGE, Q. M. S. BUSAIDY, and J. C. SMITH. "Optical Urethrotomy-Experience in Oman." British Journal of Urology 63, no. 6 (June 1989): 639–40. http://dx.doi.org/10.1111/j.1464-410x.1989.tb05261.x.

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Altınova, Serkan, and Sadi Turkan. "Optical urethrotomy using topical anesthesia." International Urology and Nephrology 39, no. 2 (January 25, 2007): 511–12. http://dx.doi.org/10.1007/s11255-006-9046-0.

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Kaisary, Amir V. "Postoperative care following internal urethrotomy." Urology 26, no. 4 (October 1985): 333–36. http://dx.doi.org/10.1016/0090-4295(85)90178-5.

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Karaguzel, Ersagun, Metin Gur, Dogan S. Tok, İlke O. Kazaz, Huseyin Eren, Omer Kutlu, and Guner K. Ozgur. "Severe Penile Curvature following Otis Urethrotomy." Case Reports in Medicine 2013 (2013): 1–3. http://dx.doi.org/10.1155/2013/214082.

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Urethral stricture is a common urological pathology with a high recurrence rate after treatment. Urethral manipulations are among its main causes. In this paper, urethral stricture developed secondary to urethral catheterization and was treated with cold-knife internal urethrotomy and the Otis urethrotomy procedure. During the follow-up period, severe ventral penile curvature preventing sexual intercourse developed due to fibrosis of the corpus spongiosum and tunica albuginea of the penis. This ventral penile curvature was corrected with a separate operation using a tunica vaginalis flap harvested from the left scrotum.

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Vicente, J., J. Salvador, and J. Caffaratti. "Endoscopic Urethrotomy versus Urethrotomy plus Nd-YAG Laser in the Treatment of Urethral Stricture." European Urology 18, no. 3 (1990): 166–68. http://dx.doi.org/10.1159/000463901.

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Kumar, Santosh, Nitin Garg, Shrawan Kumar Singh, and Arup Kumar Mandal. "Efficacy of Optical Internal Urethrotomy and Intralesional Injection of Vatsala-Santosh PGI Tri-Inject (Triamcinolone, Mitomycin C, and Hyaluronidase) in the Treatment of Anterior Urethral Stricture." Advances in Urology 2014 (2014): 1–4. http://dx.doi.org/10.1155/2014/192710.

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Purpose. To study the efficacy of optical internal urethrotomy with intralesional injection of Vatsala-Santosh PGI tri-inject (triamcinolone, mitomycin C, and hyaluronidase) in the treatment of anterior urethral stricture.Material and Methods. A total of 103 patients with symptomatic anterior urethral stricture were evaluated on the basis of clinical history, physical examination, uroflowmetry, and retrograde urethrogram preoperatively. All patients were treated with optical internal urethrotomy followed by injection of tri-inject at the urethrotomy site. Tri-inject was prepared by diluting the combination of triamcinolone 40 mg, mitomycin C 2 mg, and hyaluronidase 3000 in 5–10 mL of saline according to length of stricture. An indwelling 18 Fr silicone catheter was left in place for a period of 7–21 days. All patients were followed up for 6–18 months postoperatively on the basis of history, uroflowmetry, and, if required, retrograde urethrogram and micturating urethrogram every 3 months.Results. The overall recurrence rate after first OIU is 19.4% (20 out of 103 patients), that is, a success rate of 80.6%. Overall recurrence rate after second procedure was 5.8% (6 out of 103 patients), that is, a success rate of 94.2%.Conclusion. Optical internal urethrotomy with intralesional injection of Vatsala-Santosh PGI tri-inject (triamcinolone, mitomycin C, and hyaluronidase) is a safe and effective minimally invasive therapeutic modality for short segment anterior urethral strictures.

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Pickard, Robert, Beatriz Goulao, Sonya Carnell, Jing Shen, Graeme MacLennan, John Norrie, Matt Breckons, et al. "Open urethroplasty versus endoscopic urethrotomy for recurrent urethral stricture in men: the OPEN RCT." Health Technology Assessment 24, no. 61 (November 2020): 1–110. http://dx.doi.org/10.3310/hta24610.

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Background Men who suffer recurrence of bulbar urethral stricture have to decide between endoscopic urethrotomy and open urethroplasty to manage their urinary symptoms. Evidence of relative clinical effectiveness and cost-effectiveness is lacking. Objectives To assess benefit, harms and cost-effectiveness of open urethroplasty compared with endoscopic urethrotomy as treatment for recurrent urethral stricture in men. Design Parallel-group, open-label, patient-randomised trial of allocated intervention with 6-monthly follow-ups over 24 months. Target sample size was 210 participants providing outcome data. Participants, clinicians and local research staff could not be blinded to allocation. Central trial staff were blinded when needed. Setting UK NHS with recruitment from 38 hospital sites. Participants A total of 222 men requiring operative treatment for recurrence of bulbar urethral stricture who had received at least one previous intervention for stricture. Interventions A centralised randomisation system using random blocks allocated participants 1 : 1 to open urethroplasty (experimental group) or endoscopic urethrotomy (control group). Main outcome measures The primary clinical outcome was control of urinary symptoms. Cost-effectiveness was assessed by cost per quality-adjusted life-year (QALY) gained over 24 months. The main secondary outcome was the need for reintervention for stricture recurrence. Results The mean difference in the area under the curve of repeated measurement of voiding symptoms scored from 0 (no symptoms) to 24 (severe symptoms) between the two groups was –0.36 [95% confidence interval (CI) –1.78 to 1.02; p = 0.6]. Mean voiding symptom scores improved between baseline and 24 months after randomisation from 13.4 [standard deviation (SD) 4.5] to 6 (SD 5.5) for urethroplasty group and from 13.2 (SD 4.7) to 6.4 (SD 5.3) for urethrotomy. Reintervention was less frequent and occurred earlier in the urethroplasty group (hazard ratio 0.52, 95% CI 0.31 to 0.89; p = 0.02). There were two postoperative complications requiring reinterventions in the group that received urethroplasty and five, including one death from pulmonary embolism, in the group that received urethrotomy. Over 24 months, urethroplasty cost on average more than urethrotomy (cost difference £2148, 95% CI £689 to £3606) and resulted in a similar number of QALYs (QALY difference –0.01, 95% CI –0.17 to 0.14). Therefore, based on current evidence, urethrotomy is considered to be cost-effective. Limitations We were able to include only 69 (63%) of the 109 men allocated to urethroplasty and 90 (80%) of the 113 men allocated to urethrotomy in the primary complete-case intention-to-treat analysis. Conclusions The similar magnitude of symptom improvement seen for the two procedures over 24 months of follow-up shows that both provide effective symptom control. The lower likelihood of further intervention favours urethroplasty, but this had a higher cost over the 24 months of follow-up and was unlikely to be considered cost-effective. Future work Formulate methods to incorporate short-term disutility data into cost-effectiveness analysis. Survey pathways of care for men with urethral stricture, including the use of enhanced recovery after urethroplasty. Establish a pragmatic follow-up schedule to allow national audit of outcomes following urethral surgery with linkage to NHS Hospital Episode Statistics. Trial registration Current Controlled Trials ISRCTN98009168. Funding This project was funded by the NIHR Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 24, No. 61. See the NIHR Journals Library website for further project information.

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Bhatta, Pushupati Nath, Akash Raya, Mohammad Shahid Alam, Rishikant Aryal, and Deepak Kumar Dutta. "Role of clean intermittent self-catheterization in prevention of recurent urethral stricture after optical internal urethrotomy." Journal of Physiological Society of Nepal 1, no. 1 (June 30, 2020): 14–17. http://dx.doi.org/10.3126/jpsn.v1i1.37718.

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Introduction: Urethral stricture is one of the common urological problem. There are different option to treat urethral stricture but, irrespective of the treatment the chances of recurrence is still high. Clean intermittent self-catheterization (CISC) was introduced by Lapides has greatly reduced the chances of recurrence. So, the objectives of this randomized clinical trial was to compare the chances of recurrence in optical internal urethrotomy (OIU) patients with or without CISC. Materials and methods: A randomized controlled study conducted in the department of surgery, urology division at National medical college, Birgunj from June 2019 to June 2020. Total 97 cases of age 20-80 years with stricture up to 1-2 cm were included. All cases were randomized in two groups. Group 1 (optical internal urethrotomy with clean intermittent self-catheterization) Group 2 (optical internal urethrotomy without clean intermittent self-catheterization). Results: Among total 97 cases 4 cases from group 1 and 7 cases of group 2 lost their follow-up which were excluded from the study. Total 86 patient completed the study, 43 in treatment group 1 and 43 in control group 2. Mean age of patient was 42.58±16.147 years in group 1 and 32.07±9.917 years in group 2. Majority of patient 56 (65%) were of age 20-40 years. Recurrence of stricture was seen in 9 (20.93%) cases in group 1 and 20 (46.51%) cases in group 2. Conclusions: The study concluded that clean intermittent self-catheterization is a simple and effective way of reducing the chances of recurrence after internal optical urethrotomy.

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Kariba, Takeo, Atsushi Toyoshima, Hidetoshi Satoh, Hitoshi Tsuchida, Kenichi Eguchi, Kenji Kumagai, Tatsuo Iizumi, Tsunetada Yazaki, Masayoshi Waku, and Kohtaro Matsuse. "STUDIES OF THE OPTICAL INTERNAL URETHROTOMY." Japanese Journal of Urology 78, no. 8 (1987): 1361–64. http://dx.doi.org/10.5980/jpnjurol1928.78.8_1361.

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Cauni, V., P. Geavlete, G. Nita, and D. Georgescu. "URETHRAL ULTRASOUND VALUE IN INTERNAL URETHROTOMY." European Urology Supplements 5, no. 2 (April 2006): 44. http://dx.doi.org/10.1016/s1569-9056(06)60092-4.

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Fujita, Kimio. "Internal Urethrotomy Using a Ureteral Resectoscope." Journal of Urology 141, no. 4 (April 1989): 894. http://dx.doi.org/10.1016/s0022-5347(17)41042-1.

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Albers, Peter, Jan Fichtner, Peter Bruhl, and Stefan C. Muller. "Long-Term Results of Internal Urethrotomy." Journal of Urology 156, no. 5 (November 1996): 1611–14. http://dx.doi.org/10.1016/s0022-5347(01)65461-2.

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GREENLAND, J. E., T. H. LYNCH, and D. M. A. WALLACE. "Optical Urethrotomy under Local Urethral Anaesthesia." British Journal of Urology 67, no. 4 (April 1991): 385–88. http://dx.doi.org/10.1111/j.1464-410x.1991.tb15167.x.

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Smeak, Daniel D. "Urethrotomy and urethrostomy in the dog." Clinical Techniques in Small Animal Practice 15, no. 1 (February 2000): 25–34. http://dx.doi.org/10.1053/svms.2000.7301.

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35

Tolkach, Yuri, Thomas Herrmann, Axel Merseburger, Martin Burchardt, Mathias Wolters, Stefan Huusmann, Mario Kramer, Markus Kuczyk, and Florian Imkamp. "Development of a clinical algorithm for treating urethral strictures based on a large retrospective single-center cohort." F1000Research 5 (September 26, 2016): 2378. http://dx.doi.org/10.12688/f1000research.9427.1.

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Aim To analyze clinical data from male patients treated with urethrotomy and to develop a clinical decision algorithm. Materials and methods Two large cohorts of male patients with urethral strictures were included in this retrospective study, historical (1985-1995, n=491) and modern cohorts (1996-2006, n=470). All patients were treated with repeated internal urethrotomies (up to 9 sessions). Clinical outcomes were analyzed and systemized as a clinical decision algorithm. Results The overall recurrence rates after the first urethrotomy were 32.4% and 23% in the historical and modern cohorts, respectively. In many patients, the second procedure was also effective with the third procedure also feasible in selected patients. The strictures with a length ≤ 2 cm should be treated according to the initial length. In patients with strictures ≤ 1 cm, the second session could be recommended in all patients, but not with penile strictures, strictures related to transurethral operations or for patients who were 31-50 years of age. The third session could be effective in selected cases of idiopathic bulbar strictures. For strictures with a length of 1-2 cm, a second operation is possible for the solitary low-grade bulbar strictures, given that the age is > 50 years and the etiology is not post-transurethral resection of the prostate. For penile strictures that are 1-2 cm, urethrotomy could be attempted in solitary but not in high-grade strictures. Conclusions We present data on the treatment of urethral strictures with urethrotomy from a single center. Based on the analysis, a clinical decision algorithm was suggested, which could be a reliable basis for everyday clinical practice.

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Tolkach, Yuri, Thomas Herrmann, Axel Merseburger, Martin Burchardt, Mathias Wolters, Stefan Huusmann, Mario Kramer, Markus Kuczyk, and Florian Imkamp. "Development of a clinical algorithm for treating urethral strictures based on a large retrospective single-center cohort." F1000Research 5 (April 24, 2017): 2378. http://dx.doi.org/10.12688/f1000research.9427.2.

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Aim: To analyze clinical data from male patients treated with urethrotomy and to develop a clinical decision algorithm. Materials and methods: Two large cohorts of male patients with urethral strictures were included in this retrospective study, historical (1985-1995, n=491) and modern cohorts (1996-2006, n=470). All patients were treated with repeated internal urethrotomies (up to 9 sessions). Clinical outcomes were analyzed and systemized as a clinical decision algorithm. Results: The overall recurrence rates after the first urethrotomy were 32.4% and 23% in the historical and modern cohorts, respectively. In many patients, the second procedure was also effective with the third procedure also feasible in selected patients. The strictures with a length ≤ 2 cm should be treated according to the initial length. In patients with strictures ≤ 1 cm, the second session could be recommended in all patients, but not with penile strictures, strictures related to transurethral operations or for patients who were 31-50 years of age. The third session could be effective in selected cases of idiopathic bulbar strictures. For strictures with a length of 1-2 cm, a second operation is possible for the solitary low-grade bulbar strictures, given that the age is > 50 years and the etiology is not post-transurethral resection of the prostate. For penile strictures that are 1-2 cm, urethrotomy could be attempted in solitary but not in high-grade strictures. Conclusions: We present data on the treatment of urethral strictures with urethrotomy from a single center. Based on the analysis, a clinical decision algorithm was suggested, which could be a reliable basis for everyday clinical practice.

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AAGAARD, J., J. ANDERSEN, and P. JASZCZAK. "Direct Vision Internal Urethrotomy. A Prospective Study of 81 Primary Strictures Treated with a Single Urethrotomy." British Journal of Urology 59, no. 4 (April 1987): 328–30. http://dx.doi.org/10.1111/j.1464-410x.1987.tb04642.x.

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Pechersky, A. V., V. I. Pechersky, E. S. Shpilenya, A. H. Gaziev, and V. F. Semiglazov. "CICATRIZATION AND REGENERATION." HERALD of North-Western State Medical University named after I.I. Mechnikov 7, no. 3 (September 15, 2015): 73–82. http://dx.doi.org/10.17816/mechnikov20157373-82.

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Introduction. The cicatrix as the local site of a sclerosis, replaces wound defect or focus of a necrosis. Lead to cicatrization various type of a trauma, including operational, and also some of diseases. Cicatrization quite often leads to stricture and other complications.Materials and methods. The methodology of stimulation of regeneration for reduction of intensity of cicatrization of the damaged tissues is shown on the example of the patient from a stricture urethra.Results. In 5 months after an endoscopic urethrotomy of a stricture of bulbous part of urethra of 3 mm and the developed recurrence - the stricture of bigger length - 5 mm the repeated endoscopic urethrotomy was carried out. In 5 months after carrying out a repeated endoscopic urethrotomy and the beginning of the complex treatment directed on stimulation of regeneration and prevention of formation of cicatricial tissue according to a control urethrography the bulbous part of urethra was passable.Conclusion. Complex stimulation of regeneration taking into account a role of immune system in this process, on an equal basis with purpose of proteolytic ferment preparations, can be used for reduction of expressiveness of sclerosis of the damaged tissues.

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Heberling, Ulrike, Michael Fröhner, Sven Oehlschläger, and Manfred P. Wirth. "Superglue in the Urethra: Surgical Treatment." Urologia Internationalis 96, no. 1 (August 7, 2014): 119–21. http://dx.doi.org/10.1159/000360586.

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Mangera, Altaf, Nadir Osman, and Christopher R. Chapple. "Evaluation and management of anterior urethral stricture disease." F1000Research 5 (February 9, 2016): 153. http://dx.doi.org/10.12688/f1000research.7121.1.

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Urethral stricture disease affects many men worldwide. Traditionally, the investigation of choice has been urethrography and the management of choice has been urethrotomy/dilatation. In this review, we discuss the evidence behind the use of ultrasonography in stricture assessment. We also discuss the factors a surgeon should consider when deciding the management options with each individual patient. Not all strictures are identical and surgeons should appreciate the poor long-term results of urethrotomy/dilatation for strictures longer than 2 cm, strictures in the penile urethra, recurrent strictures, and strictures secondary to lichen sclerosus. These patients may benefit from primary urethroplasty if they have many adverse features or secondary urethroplasty after the first recurrence.

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Modh, Rishi, Peter Y. Cai, Alyssa Sheffield, and Lawrence L. Yeung. "Outcomes of Direct Vision Internal Urethrotomy for Bulbar Urethral Strictures: Technique Modification with High Dose Triamcinolone Injection." Advances in Urology 2015 (2015): 1–5. http://dx.doi.org/10.1155/2015/281969.

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Objective. To evaluate the recurrence rate of bulbar urethral strictures managed with cold knife direct vision internal urethrotomy and high dose corticosteroid injection.Methods. 28 patients with bulbar urethral strictures underwent direct vision internal urethrotomy with high dose triamcinolone injection into the periurethral tissue and were followed up for recurrence.Results. Our cohort had a mean age of 60 years and average stricture length of 1.85 cm, and 71% underwent multiple previous urethral stricture procedures with an average of 5.7 procedures each. Our technique modification of high dose corticosteroid injection had a recurrence rate of 29% at a mean follow-up of 20 months with a low rate of urinary tract infections. In patients who failed treatment, mean time to stricture recurrence was 7 months. Patients who were successfully treated had significantly better International Prostate Symptom Scores at 6, 9, and 12 months. There was no significant difference in maximum flow velocity on Uroflowmetry at last follow-up but there was significant difference in length of follow-up (p=0.02).Conclusions. High dose corticosteroid injection at the time of direct vision internal urethrotomy is a safe and effective procedure to delay anatomical and symptomatic recurrence of bulbar urethral strictures, particularly in those who are poor candidates for urethroplasty.

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Ahmed, M., SM Hossain, MT Islam, G. Kobir, and BK Basu. "Use of intra-urethral steroid clobetasol cream to prevent the recurrence of urethral stricture after optical urethrotomy: Randomized clinical trial." Mediscope 6, no. 2 (September 16, 2019): 59–63. http://dx.doi.org/10.3329/mediscope.v6i2.43154.

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Background: One of the most frequently used treatments of urethral strictures is the optical internal urethrotomy (OIU). About 20%-60% of urethral stricture patients develop recurrent stricture after Urethrotomy. Glucocorticoids have proved anti-proliferative effect and thereby used to reduce the formation of scar tissue. In urethral stricture, the main pathology is scar tissue formation. Objective: The aim of this study is to see the influence the local application of steroid clobetasol cream after Urethrotomy. Method: Between January to December 2016, all Bulbar urethral stricture patients attended to the hospital and private clinics, were included in this study. They were placed in two groups alternatively. They underwent standard OIU. First group (35 patients) offered clean intermittent self-catheterization (CISC) postoperatively without any steroid cream in urethra. The second group (35 patients) practiced CISC in the same way but used clobetasol cream with catheter. Both groups used topical anaesthesic Lidocain HCL for lubrication of urethra. Result: No patient developed recurrence with clobetasol cream after 3 months, but two patients developed recurrence without steroid. At 6 months, this result is 6 (17.14%) and 10 (28.57%) accordingly. Conclusion: Topical steroid clobetasol cream reduces urethral stricture recurrence. Mediscope Vol. 6, No. 2: Jul 2019, Page 59-63

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Basaif, Wedyan Salem, Husam Hamad Alamri, Hind Waleed Mousa, Raghad Abdulelah Alsayed, Abdullah Mohammed Almohammadi, Waleed Hamed Altulayqi, Abdulrahman Mohammed Albejawi, et al. "Types of urethral stricture and their recurrence rates post urological treatments." International Journal Of Community Medicine And Public Health 8, no. 7 (June 25, 2021): 3634. http://dx.doi.org/10.18203/2394-6040.ijcmph20212347.

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Urethral strictures can significantly impact the quality of life for patients because it can be associated with significant complications such as fistulas, bladder calculi, infections and sepsis. Additionally, it might even lead to renal failure. The worldwide prevalence of urethral strictures is high, with an estimated rate of 229-627 patients per 100,000 population. In this literature review, the aim was to discuss the types and etiology of urethral strictures and the recurrence rates following the different management modalities. Studies that were included in this review were published between January 2005 until May 2021. The results support the current evidence that the idiopathic and iatrogenic bulbar strictures are the most common types while penile strictures, the iatrogenic and inflammatory are the most common causes. Recurrence rates are reported after management with almost all of the current management modalities, indicating the need for better interventions to enhance the outcomes and alleviate the quality of care. The recurrence rate of strictures after treatment with internal urethrotomy and direct vision internal urethrotomy by three years is 65%. Other studies reported that the rate of recurrence was estimated to be around 14 after 6 months from internal urethrotomy and up to 27% after 12 months. The rate of complications and recurrence following treatment with anastomotic urethroplasty was estimated to be less than 5%. Detailed information and discussion were provided in the study manuscript.

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Sinha, S., and M. V. Ramesh Babu. "Direct vision internal urethrotomy using topical anesthesia." Urology 44, no. 4 (October 1994): 625. http://dx.doi.org/10.1016/s0090-4295(94)80076-6.

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Graversen, Peder H., Palle Rosenkilde, and Hans Colstrup. "Erectile Dysfunction following Direct Vision Internal Urethrotomy." Scandinavian Journal of Urology and Nephrology 25, no. 3 (January 1991): 175–78. http://dx.doi.org/10.3109/00365599109107943.

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Soligo, M., G. Franchini, A. Morlacco, F. Zattoni, F. Dal Moro, P. Beltrami, A. Calpista, and F. Zattoni. "Predictive factors of Sachse endoscopic urethrotomy failure." European Urology Supplements 16, no. 3 (March 2017): e1778-e1779. http://dx.doi.org/10.1016/s1569-9056(17)31072-2.

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Chen, Gregory L., and Richard E. Berger. "Treatment of Impotence Resulting from Internal Urethrotomy." Journal of Urology 158, no. 2 (August 1997): 542. http://dx.doi.org/10.1016/s0022-5347(01)64532-4.

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Parker, Walter R., Jeffery Wheat, Jeffrey S. Montgomery, and Jerilyn M. Latini. "Urethral Diverticulum After Endoscopic Urethrotomy: Case Report." Urology 70, no. 5 (November 2007): 1008.e5–1008.e7. http://dx.doi.org/10.1016/j.urology.2007.08.022.

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Venugopal, S., D. Schoeman, A. Farrier, S. Das, C. Powell, and B. Pettersson. "UP-2.75: Outcome of daycase optical urethrotomy." Urology 76, no. 3 (September 2010): S105—S106. http://dx.doi.org/10.1016/j.urology.2010.07.309.

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MURDOCH, D. A., and D. F. BADENOCH. "Oral Ciprofloxacin as Prophylaxis for Optical Urethrotomy." British Journal of Urology 60, no. 4 (October 1987): 352–54. http://dx.doi.org/10.1111/j.1464-410x.1987.tb04984.x.

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