SEARCH · PubMed Health

Results for “Urethral Stricture”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 91 records · Page 5Linked to original sources

PubMed2006

Risk factors for the development of prostate brachytherapy related urethral strictures.

PURPOSE: We identified clinical, treatment and dosimetric parameters associated with the development of urethral strictures following permanent prostate brachytherapy. MATERIALS AND METHODS: From April 1995 through April 2003, 1,186 consecutive patients underwent prostate brachytherapy for clinical stage T1b-T3a NxM0 (2002 American Joint Committee on Cancer) prostate cancer. The treatment plan included supplemental XRT in 625 patients (52.7%) and androgen deprivation therapy in 465 (39.2%). Median followup was 4.3 years. Multiple clinical, treatment and dosimetric parameters were evaluated in univariate and multivariate analyses to identify independent predictors for urethral stricture disease. RESULTS: A total of 29 patients had brachytherapy related urethral strictures. All strictures involved the BM urethra with a 9-year actuarial risk of 3.6% and a median time to development of 2.4 years. The mean radiation dose to the BM urethra was significantly greater in patients with vs without stricture (p = 0.002). On multivariate analysis the BM urethral dose and supplemental XRT predicted urethral stricture. All except 3 patients were successfully treated with urethral dilation or internal optical urethrotomy. CONCLUSIONS: Brachytherapy related urethral stricture disease correlates highly with the radiation dose to the BM urethra. Careful attention to brachytherapy preplanning and intraoperative execution along with the judicious use of supplemental XRT is essential to minimize the incidence of stricture disease.

Aged↗

PubMed1985

Impassable urethral strictures: percutaneous transvesical catheterization and balloon dilatation.

Urethral strictures that are impassable in retrograde fashion present a special problem to the urologist because they cannot be managed by standard dilatation techniques or direct-vision internal urethrotomy. Open urethroplasty is usually required. We describe a technique to catheterize the urethra in an antegrade fashion and dilate the strictures. Our study involved six patients with impassable urethral strictures that were successfully traversed and dilated. Percutaneous transvesical antegrade catheterization and balloon dilatation are beneficial for patients with bladder outlet obstruction.

Aged↗

PubMed1993

[Antegrade-retrograde urethrotomy in therapy of high degree urethral stricture].

In the case of urethral stricture which is non-passable by conventional "cold knife" urethrotomy, open urethroplasty can be avoided by combined antegrade-retrograde urethrotomy (ARUT). A rigid cystoscope is guided, through a dilated, suprapubic cystostomy channel, to the stricture in the membranous or bulbular urethra. A urethrotome is inserted in the retrograde direction and the "cut to the light" procedure is adopted. Using the ARUT method, successful realignment was achieved in 9 patients; 4 strictures were trauma- or urethritis-induced and 5 were the result of transurethral management. Recurrent stricture in 4 out of 7 cases (57%) required further urethrotomy. There was no recurrence in 4 out of 7 patients for at least 5 months subsequent to the last treatment. All patients were spared open surgery. The antegrade-retrograde technique exists since 1978. Up to date, 63 cases have been mentioned in the literature. The primary therapy success rate is 25%. Successful retreatment following recurrence was observed in 65%. We recommend ARUT as first-choice treatment for severe strictures of the bulbular and membranous urethra.

Adult↗

PubMed1988

Balloon dilatation of iatrogenic urethral strictures.

Balloon dilatation of the urethra was performed in five patients with iatrogenic urethral strictures. The urethral strictures were successfully negotiated and dilated in all patients. Redilatation became necessary in a period ranging from 3 to 10 months. The authors believe that balloon dilatation of the urethra can be safely and successfully performed; the procedure produces minimal trauma and immediate relief of symptoms.

Aged↗

PubMed1977

Transpubic urethroplasty for membranous urethral strictures.

Six patients with traumatic membranous urethral strictures have undergone urethroplasty utilizing the traspubic approach with resection of a wedge of the symphysis pubis. Three patients are free of stricture, 2 required urethral dilatation in the early postoperative period only, and 1 patient requires dilation every three months. Four patients are completely continent of urine, 1 has mild stress incontinence, and 1 is incontinent because of a neurogenic bladder. This approach provides excellent exposure with minimal morbidity and allows an easy under-vision anastomosis.

Adult↗

PubMed1992

Urethral stricture in children: treatment by urethroplasty with bladder mucosa graft.

Urethral strictures in children, which are not frequent, often require urethroplasty when dilations and/ or urethrotomies have failed. A bladder mucosa graft was used successfully for urethral reconstruction to treat posterior hypospadias. We describe our experience with a bladder mucosa graft during urethroplasty for acquired urethral strictures in 8 children. Urethral strictures secondary to the treatment of hypospadias were excluded. Bladder mucosa was used successfully as an onlay or patch graft urethroplasty in 7 patients. One patient had a tubularized graft with secondary stenosis treated successfully by dilation.

Adolescent↗

PubMed2005

Anterior urethral strictures: etiology and characteristics.

OBJECTIVES: To evaluate the etiology and characteristics of symptomatic anterior urethral strictures in a large series of men presenting for urologic treatment in an effort to determine the common themes that may influence possible prevention or treatment strategies. Many questions about the origin and features of contemporary anterior urethral stricture disease remain unanswered. METHODS: The records of 175 men with symptomatic anterior urethral strictures were reviewed. Data were entered both prospectively by careful patient questioning and retrospectively from detailed chart review. The stricture length, location, and cause were recorded from urologic presentation, before definitive treatment. Posterior strictures from pelvic fracture urethral disruption defects were excluded from this review. RESULTS: A total of 194 strictures were identified in 175 men. Most strictures were idiopathic (65 of 194, 34%) or iatrogenic (63 of 194, 32%); fewer were inflammatory (38 of 194, 20%) or traumatic (28 of 194, 14%). Most involved the bulbar urethra (n = 100, 52%). Pendulous strictures (mean 6.1 cm) were longer on average than those in the fossa navicularis (mean 2.6 cm) or bulb (mean 3.1 cm). Prolonged catheterization (n = 26) and transurethral surgery (n = 25) were common causes of iatrogenic strictures. CONCLUSIONS: Our results showed that idiopathic and iatrogenic strictures are surprisingly common. External trauma was a relatively uncommon cause of anterior urethral stricture disease overall. Unnecessary urethral catheterization and repeated urethral instrumentation should be avoided to prevent stricture formation or exacerbation. More study is necessary to determine the origin of anterior urethral stricture disease.

Humans↗

PubMed2004

[Reconstruction of complex urethral stricture with free postauricular graft].

OBJECTIVE: To explore and describe the clinical feasibility and value of reconstruction of complex urethral stricture with free postauricular graft. METHODS: Urethroplasties with free postauricular grafts were performed in 17 patients with complex urethral strictures, including 6 cases in anterior urethras and 11 cases in posterior urethras. The grafts were transplanted onto the opened urethras in the first stage; 6 months later, the new urethras were shaped with the second stage urethroplasties in 14 patients. There patients succeeded in single-stage urethroplasties. The urethras and bladders were washed with antibiotic solution everyday after urethroplasties. RESULTS: Good and satisfactory results were obtained in 15 cases 6 months after urethroplasties, regardless of the strictured sites and lengths. Maximal urinary flow rates ranged 14-32 ml/s. There were 2 cases accompanied with complications 6 months after urethroplasties, 1 case of fistula was repaired, 1 case of severe urethral stricture was reconstructed with opposite side free postauricular graft later. Three patients had mild urethral strictures 6 months after urethroplasties, they were cured with urethral dilatations for 4-8 times. CONCLUSION: Reconstruction of complex urethral stricture with free postauricular graft is a good and effective method to treat long or complex urethral strictures, especially for patients without adequate foreskin or penis skin.

Adolescent↗

PubMed1999

Iatrogenic prostatic urethral strictures: classification and endoscopic treatment.

OBJECTIVES: The treatment of posterior urethral strictures is a controversial subject. For proper treatment, it is important to differentiate between iatrogenic prostatic urethral strictures and post-traumatic membranous urethral strictures. METHODS: Iatrogenic strictures of the prostatic urethra have been classified according to location and etiology into three categories: type I, located exclusively at the bladder neck; type II, located in the midportion of the prostatic fossa; and type III, when the whole prostatic fossa is replaced by stricture. From 1970 to 1996, 163 patients with postoperative strictures of the prostatic urethra were treated endoscopically. RESULTS: The results obtained in 122 patients are reported; 41 patients are not evaluable. The median follow-up was 63 months (range 12 to 239). Seven patients required a second endoscopic procedure to attain cure. Good results were achieved in 54 (91%) of 59 patients with type I strictures, in 45 (98%) of 46 patients with type II strictures, and in 13 (76%) of 17 patients with type III strictures. The overall success rate was 92% (112 of 122). Complications occurred in 21 patients (17%), including postoperative urinary tract infection (11%), incontinence (4%), stress incontinence (1%), and severe bleeding (1%). CONCLUSIONS: Postoperative strictures of the prostatic urethra must be recognized and can be easily treated with endoscopic therapy.

Aged↗

PubMed2002

A prospective, randomized protocol to examine the efficacy of postinternal urethrotomy dilations for recurrent bulbomembranous urethral strictures.

OBJECTIVES: The high recurrence rate is still the major complication of endoscopic treatment of urethral stricture disease. To compare the outcome of patients who underwent direct vision internal urethrotomy (DVIU) and then followed a protocol that randomized them to either our urethral dilation protocol or consecutive DVIUs for the treatment of their urethral stricture. METHODS: A total of 37 patients, who had undergone at least two DVIUs to treat their recurrent urethral strictures, were enrolled in this study. They were randomized into two groups. The etiology and location of the strictures were similar, and their length ranged from 0.5 to 2 cm in each group. In group 1 (n = 18), the patients were observed by regular visits and uroflowmetry profiles after the initial DVIU and consecutive DVIUs were considered when the stricture recurred. In group 2 (n = 19), patients received urethral dilations with Benique dilatators (maximal 21F) under intraurethral anesthesia, beginning 10 days after the initial internal urethrotomy, according to the following protocol: weekly for the first month, once after 3 and after 6 months, and then once each year. RESULTS: After a median follow-up of 30 months, the urethral stricture recurred within 12 months in 55.6% (n = 10) of group 1, and consecutive DVIUs were indicated. During the same follow-up period, recurrence was observed in 2 patients (10.5%), 9 months and 2 years after randomization, in group 2 (P <0.05). The mean maximal urinary flow rate in groups 1 and 2 at last follow-up was 7.8 +/- 3.7 and 21.0 +/- 8.7 mL/s, respectively (P <0.01). CONCLUSIONS: We suggest a regular, simple urethral dilation protocol for patients with recurrent bulbomembranous urethral stricture shorter than 2 cm, because this significantly allays the stricture recurrence rate, possibly eliminates the need for consecutive DVIU, and reduces morbidity.

Adult↗

PubMed2002

Use of pedicle flap from the labia minora for the repair of female urethral strictures.

INTRODUCTION: We present the method of pedicle labial urethroplasty for urethral reconstruction in female patients treated for urethral strictures. PATIENTS AND METHODS: We performed urethral reconstruction using a pedicle labial flap in 2 female patients (23 and 70 years old) for urethral stricture (posttraumatic and postinflammatory origin). We used as a patch a pedicle skin flap obtained from the labia minora. The pedicle flap is slid beneath the vulvovaginal wall, until the urethra is reached. RESULTS: In both cases a normal micturition was obtained, and cystourethrography after 24 months showed a good urethral silhouette, without residual urine. CONCLUSION: The pedicle labial urethroplasty seems to be a reliable technique for the repair of urethral strictures.

Adult↗

PubMed1992

[Urethral stricture in Greenland].

In a retrospective survey, the 46 patients treated for urethral stricture at Dronning Ingrids Hospital, Nuuk, (the main hospital in Greenland) during the four year period August 1987-August 1991 are investigated, and the consequences of not treating urethral stricture are illustrated by a case. The patients are middleaged and older men generally with long and multiple strictures close to the sphincter. Gonorrhoea is the common cause of the stricture. The patients have obstructive symptoms, urinary infections and haematuria. Furthermore, nearly 1/4 of the patients have complications in the form of scrotal and perineal abscesses, and reduced renalfunction and rapidly lethal disease because of sepsis are seen. The urethral strictures tend to recur after treatment. Urethral stricture disease is undoubtedly underestimated in Greenland, and the investigation stresses this serious complication of venereal disease.

Adult↗

PubMed2002

Patient satisfaction with the outcome of surgery for urethral stricture.

PURPOSE: We assessed patient satisfaction with the outcome of surgery for urethral strictures and compared it with objective clinical data. MATERIALS AND METHODS: A total of 267 consecutive patients who underwent surgery for urethral stricture between March 1993 and December 1999 were questioned regarding satisfaction. Mailed questionnaires or a telephone interview, if questionnaires were not returned, provided information on the urinary tract, voiding, sexual function, overall satisfaction and miscellaneous impairments after surgery for urethral strictures. The response rate was 87% (233 of 267 patients). Subjective data were compared with objective clinical findings. RESULTS: Of the 203 patients who underwent successful urethroplasty 159 (78%) and 24 of the 30 (80%) in whom urethroplasty was considered a failure from the physician viewpoint were satisfied or very satisfied with the outcome of urethral surgery. Patients who underwent re-intervention for complications other than re-stricture and those who complained of a weak or very weak urinary stream were considerably less satisfied. Factors influencing sexual function also had an important impact on patient satisfaction. Patients with marked or severe penile curvature, penile shortening, erection deterioration and a markedly or severely impaired sexual life were especially dissatisfied. CONCLUSIONS: Patients consider the outcome of surgery for urethral strictures differently than physicians. The outcome of urethroplasty should be assessed not only by objective, but also by subjective criteria. Patients need appropriate preoperative counseling. With realistic expectations most men are satisfied with surgery for urethral stricture.

Adult↗

PubMed2004

Lichen sclerosus of the male genitalia and urethral stricture diseases.

INTRODUCTION: The true incidence of urethral involvement in patients with genital lichen sclerosus (LS) is unknown. We review the epidemiology and discuss the pathogenesis of LS and urethral stricture diseases. MATERIALS AND METHODS: During the period 1991-2002, of 925 patients who underwent urethroplasty for anterior urethral stricture, 130 patients (14%) received the diagnosis of LS. In all patients with LS the histology was re-examined to confirm the clinical diagnosis. Retrograde and voiding urethrography was used to establish urethral involvement in the disease. RESULTS: In 106 patients (82%) the histology provided the classical features of LS, and 24 patients (18%) showed some histological variations. In 49 patients (37%) the LS involved the pendolous urethra (meatus-navicularis-penile), and in 53 cases (41%) a panurethral stricture was evident. CONCLUSIONS: LS urethral involvement appears to be a much more common and extensive disease than previously reported, and requires particular care in its early diagnosis.

Adolescent↗

PubMed1993

Absence of urethral strictures with suprapubic urinary drainage during extracorporeal circulation.

Postoperative urethral strictures following extracorporeal circulation in open heart surgery are not uncommon. The etiology is not clear. Ischemia and pressure of the Foley catheter may cause a lesion that eventually leads to urethral stricture. We retrospectively analyzed 300 patients who had undergone open heart surgery. In 1 group the bladder was drained by a Foley catheter during extracorporeal circulation, while another group underwent suprapubic drainage. Strictures developed in 10 of 152 patients (6.6%) with an indwelling catheter. Conversely, no strictures occurred in the 148 patients treated with suprapubic urinary drainage. The use of suprapubic drainage during extracorporeal circulation greatly decreases the risk of postoperative urethral strictures.

Adolescent↗

PubMed2003

Anterior urethral strictures.

The surgical treatment of adult anterior urethral strictures has developed continuously. Recently considerable changes have been introduced, involving the cause of the urethral disease and surgical techniques. The criteria for selecting the reconstructive surgical technique are presented according to the cause and a new classification of urethral strictures. The main surgical procedures are presented and fully illustrated, with an updated and comprehensive review of recent publications.

Humans↗

PubMed2005

Reconfigured sigmoid colon neourethra: substitution of refractory posterior urethral stricture.

The repair of extensive posterior urethral stricture often poses a therapeutic dilemma, especially when the urethral defect is too extensive to be repaired with traditional methods and the stricture portion has a poor blood supply. This report details the successful substitution of an extensive posterior urethral stricture using a reconfigured sigmoid colon neourethra.

Colon, Sigmoid↗

PubMed1977

The anatomy of the urethral stricture.

A post-mortem study of the urethral anatomy following gonorrhoea is presented. The different specimens examined demonstrated lesions ranging from microscopic submucosal scars to fully developed urethral strictures. In every specimen extensive squamous metaplasia of the surface epithelium was present. It is postulated that overstretching of this unsupported squamous epithelium during voiding causes microscopic epithelial tears and that the accumulation of the subsequent microscopic scars leads to the formation of a urethral stricture. Bacterial infection does not seem to play any part in the genesis of the stricture.

Adult↗