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At least 19 recordsLinked to original sources
PubMed1990

Use of the Wallstent endourethral prosthesis in the treatment of recurrent urethral strictures.

Urethral strictures recur in about 30% of the cases irrespective of treatment. We describe a new urethral stent, originally developed in our institution for vascular use after transluminal angioplasty. We have previously tested the biocompatibility and tolerance in the normal urethra of dogs in a study with a 1-year follow-up undertaken in 1986. The stent has a braided structure, made of fine stainless steel wires and is self-expanding when released from a special endoscopic instrument. Since November 1987, we have implanted the stent in 25 men (mean age 54 years), after a previous urethrotomy had been performed. Eighteen were evaluated. Results are good, morbidity and complications occasional. This new technique has a considerable future in treating recurrent urethral stricture.

Adult↗
PubMed1975

Use of the Otis urethrotome in the treatment of urethral strictures and congenital urethral stenoses.

Internal urethrotomy using the Otis urethrotome is described in detail. Performing this procedure in 23 patients with urethral strictures, no further dilatations of the urethra were necessary in approximately 60%. If internal urethrotomy, which offers the advantages of having a very low rate of complications and which may be repeated, proves unsuccessful, a urethroplasty can still be carried out. As a preliminary procedure to transurethral resection of the prostate by cold punch technique, internal urethrotomy appears to be of great value in preventing urethral strictures - as demonstrated by follow-up studies in 351 patients.

Adult↗
PubMed1989

Sonourethrography in the evaluation of urethral stricture disease.

Ultrasonography of the anterior urethra offers a dynamic three-dimensional study that can easily be repeated. It holds the promise of defining accurately, not only the exact length and severity of the strictured urethral segment, but also the extent of urethral fibrosis and the anatomy of the periurethral structures. A significant reduction in the incidence of recurrent stricture may be obtained by selecting patients for treatment on the basis of the findings of sonourethrography. Moreover, the potential exists for the use of this imaging method during internal urethrotomy to ensure a more accurate and aggressive incision of the stricture.

Humans↗
PubMed1991

Treatment of posterior urethral strictures with a titanium urethral stent.

A total of 5 patients with recurrent posterior urethral strictures underwent endoscopic placement of an expandable endourethral stent made of titanium. Patient age ranged from 17 to 66 years (mean age 42.6 years). Followup ranged from 13 to 20 months (mean 14.1 months). Of the patients 4 presently have unobstructed voiding with no incontinence. To date no side effects have been directly related to the stents and no incrustations or calculi have formed. Our preliminary study supports the use of titanium urethral stents as an alternative form of treatment for selected urethral strictures.

Adolescent↗
PubMed1989

A new treatment for urethral strictures: a permanently implanted urethral stent.

We describe a new urethral stent, originally developed for endovascular use, that we have implanted into 8 patients with urethral strictures. The stent is woven in the form of a tubular mesh from surgical grade stainless steel wire and is self-expanding when released from its small diameter delivery catheter. All patients have been treated successfully with a good caliber urethra visible on urethrography and direct endoscopy, and with improved urine flow rates. Mean followup of these patients is 8 months (range 6 months to 1 year). Urethroscopy had demonstrated complete epithelial covering of the implant at 4 to 6 months. Although the followup is short it seems that this simple technique may offer a lasting treatment for many urethral strictures.

Adult↗
PubMed1988

A new treatment for urethral strictures.

A urethral stent, originally developed for endovascular use, was implanted into eight patients with urethral strictures after experimental studies in the canine urethra. The stent is woven in the form of a tubular mesh from surgical grade stainless steel wire and is self-expanding when released from its small-diameter delivery catheter. At follow-up 6 months to 1 year postoperatively (mean 8 months) all had a good calibre urethra. Urethroscopy showed complete epithelial covering of the implant at 4-6 months.

Adult↗
PubMed1992

Surgical management of urethral strictures based on etiology. Where do urethral stents fit in?

Recent studies in the urologic literature indicate a renewed interest in the management of urethral stricture disease. Specifically, urologists are now treating all types of urethral strictures regardless of location, etiology, or extent with methods other than primary urethroplasty or direct vision internal urethrotomy (DVIU), i.e., balloon dilation or urethral stenting. To see which patients might best be managed by these new modalities, we reviewed our experience with urethral strictures at LAC-USC Medical Center.

Humans↗
PubMed1990

Urethral strictures and aortic surgery. Suprapubic rather than urethral catheters.

Urethral strictures associated with the use of a urethral catheter may be more common after cardiac and aortic surgery when compared with other surgical procedures. The reasons for this are obscure. Fifty-two aortic procedures in males from 1980-1983 were reviewed with an incidence of urethral stricture of 21%. Forty anterior resections of the rectum in which a urethral catheter was used were also reviewed with an incidence of urethral stricture of only 5%. Since 1985 supra-pubic catheters have been used now in over 200 aortic procedures with no morbidity and no urethral stricture. Bacteriuria has been significantly reduced by the use of supra-pubic catheters and there would appear to be considerable advantages in the use of this technique.

Aged↗
PubMed1989

Perineal repair of membranous urethral stricture.

Membranous urethral disruption secondary to pelvic fracture often results in an obliterative stricture. Most of these lesions can be repaired by a one-stage procedure provided certain maneuvers are accomplished to facilitate approximation of the bulbar to the prostatic urethra: urethral mobilization as far proximal as the suspensory ligament of the penis, separation of the corporal bodies, excision of a wedge of the inferior surface of the pubis exposed by corporal body separation, and on occasion, routing of the mobilized urethra around the corporal body. With these methods, even lengthy defects can be bridged to create a tension-free anastomosis.

Anastomosis, Surgical↗
PubMed1990

Urethral stricture following transurethral prostatectomy.

Urethral stricture is the most common late complication of transurethral prostatectomy. Uroflowmetry is recommended as the routine screening procedure for strictures postoperatively. If maximal urinary flow rate (Qmax) is below 10 mL/second the patients should be investigated further. The etiology of urethral stricture is still unclear. Further studies are necessary to evaluate the possible etiologic role of infected urine pre- and/or postoperatively, urethral catheterization pre- and postoperatively, catheter material, and the type and size of the resectoscope. A narrow urethra is probably a predisposing factor for stricture formation, but this is not definitively clarified. Only few randomized studies have been performed to evaluate the different prophylactic methods against development of strictures postresection. Resection via perineal urethrotomy, perhaps preceded by urethral calibration, seems to be a way to avoid anterior urethral strictures. The effects of internal urethrotomy preoperatively on stricture formation are conflicting. Further randomized studies are necessary.

Humans↗
PubMed1990

Etiology, diagnosis, and management of urethral strictures in children.

Urethral strictures in children, like those in adults, are problems whose management embodies all that is basic to urology. It is helpful to think of strictures according to etiology: congenital, infectious-inflammatory, and traumatic (iatrogenic and noniatrogenic). The treatment options are diversion (nearly always temporary), manipulation, and repair. The authors also review their research on urethral healing.

Child↗
PubMed1990

[Urethral stricture].

The incidence of urethral stricture has increased since the introduction of gonorrhoea to Europe in the 15th century. Nowadays, transurethral instrumentations and catheterisations are responsible for the majority of the urethral strictures. The mechanism is inflammatory or traumatic lesion of the urethral epithelium causing extravasation of urine and fibrosis. The symptoms often suggest to infravesical obstruction. The diagnosis is made from the patient's history in combination with flowmetry, ante- and/or retrograde urethrography, external ultrasound examination or urethral calibration and is verified at urethroscopy. Dilatation is relatively simple but seldom curative and carries a considerable morbidity. Urethrotomy is very common but also hampered with a high rate of recurrence. A technique where urethrotomy is followed by intermittent self-catheterisation or implantation of a selfexpanding wire netting seems promising but needs further investigation. Reconstructive operations in form of a free or pedicled skin island patch, skin tube graft, endourethral free split skin graft, multistaged urethroplasty, meatoplasty and excision of prostatomebraneous stricture are followed by cure in 50-95% of the cases.

Humans↗
PubMed1988

Balloon catheter dilatation of urethral strictures.

Seven patients with urethral strictures due to different causes were treated by balloon catheter dilatation. The dilatation was performed on an outpatient basis in conjunction with suprapubic voiding cystourethrography and under fluoroscopic control. Only diazepam sedation and topical anesthesia were used. No indwelling catheters were placed in the urethra after the procedure. Six of the seven patients have been followed for 6-26 months, and only two have required redilatations. There have been no complications that required therapy. The initial success with our technique and that reported by others suggest that balloon catheter dilatation offers a good alternative treatment for urethral strictures to replace bouginage, urethrotomy, and urethroplasty.

Adolescent↗
PubMed1990

[Retrograde balloon catheter dilatation of urethral stenosis--experience in benign prostatic hypertrophy and postoperative urethral stricture].

Retrograde transurethral balloon dilatation of urethral stenosis was performed in five patients: four patients with benign prostatic hypertrophy and one with urethral stricture following open prostatectomy. Significant resolution of symptoms of dysuria was seen in four patients throughout the follow-up period of 12 to 18 months. A balloon diameter of 25 mm was considered to be necessary for prostatic hypertrophy. The unsatisfactory result in one patient with prostatic hypertrophy was believed to be caused by incomplete dilation due to a small balloon diameter. Mild transient hematuria was seen in all cases. Only one patient with postoperative urethral stricture complained of pain during balloon inflation, while other patients with prostatic hypertrophy did not complain of any apparent pain. We conclude that this technique is a safe and effective method of treatment for prostatic hypertrophy and other urethral strictures.

Aged↗
PubMed1991

Balloon dilatation for entire urethral stricture.

Two patients with entire urethral stricture were treated with balloon dilatation of the whole urethra using a torpedo-type dilatation balloon with satisfactory results. Postdilatation urethrograms revealed that the lumen of the urethra was of satisfactory width in both cases, and the patients are now voiding normally. There has been no complication requiring therapy. These successful results suggest that this technique is a good alternative treatment for entire urethral stricture, and can replace conventional dilatation.

Aged↗
PubMedDate not supplied

[Treatment results in urethral strictures].

A total of 231 patients with urethral strictures were treated. The disease resulted from trauma, adenomectomy, chronic urethritis, prostatic sclerosis in 92, 72, 51 and 16 patients, respectively. Fifty-one patients underwent conservative treatment which involved bougienage, resolving and anti-inflammatory agents. 38 of them responded, 13 nonresponders were operated on. 72 patients were subjected to partial urethral tunneling according to an original technique which brought success in 90% of the cases. Out of 92 traumatic urethral strictures 88 were cured after end-to-end plastic reconstruction. It is believed that urethral strictures should be managed individually basing on the stricture cause, location, length, severity, complications.

Age Factors↗