Visual internal urethrotomy may be a reasonable initial procedure of complete and incomplete urethral stricture before planning more extensive urethroplasty. However, it is essential to recognize its limitation because careless use can result in complications. So we have experienced 88 cases of complete and incomplete urethral stricture treated by visual internal urethrotomy. 1. In non-obliterated urethral stricture, satisfactory results were achieved in 57 of patients(78 %) after urethrotomy. Patients with more than 2cm long stricture and multiple strictures had the most unsatisfactory results ( required multiple urethrotomy). 2. In obliterated urethral stricture, 54 procedures of urethrotomy were carried out in 15 patients with complete urethral obstruction(average : 3.6times). When stricture was less than 1cm in length, good results were obtained in spite of several recurrences. However, when complete urethral stricture was more than 1cm in length, all patients failed due to recurred strictures. These results suggest that visual internal urethrotomy is a valuable initial method before urethroplasty, when stricture is less than 1cm in length in cases of complete urethral obstruction.
Constriction, Pathologic ; Humans ; Recurrence ; Urethral Obstruction ; Urethral Stricture*

Endoscopic intraluminal implantation of a self expandable stent has been increasing in patients with recurrent urethral strictures because of its simple and relative safe technique. There has been a few reports concerning luminal obstruction after implantation of Wallstent. We have experienced 4 cases of urethral obstruction after variable period of Wallstent implantation in the treatment of traumatic urethral stricture. Herein the methods for treatment of urethral obstruction are discussed. The patients were managed with two different types of treatment. The first one was transurethral resection of granulation tissue inside Wallstent. The other is reinsertion of Wallstent inside the first one after transluminal resection of granulation tissue in patients with urethral obstruction occurring within 5 months after Wallstent implantation. Retrograde urethrography and urethroscopy after 3 months have demonstrated patency of urethra and epithelial covering of the implant. Our experience shows that in all 4 patients with traumatic urethral stricture have developed variable degrees of urethral obstruction after a variable period of wallstent implantation. Therefore, we consider that our method is one of the alternatives to treat urethral obstruction after wallstent implantation in patients with traumatic urethral stricture.
Granulation Tissue ; Humans ; Phenobarbital ; Stents ; Urethra ; Urethral Obstruction* ; Urethral Stricture*

Congenital urethral polyps are uncommon cause of urethral obstruction in male subjects. And polyps of the anterior urethra are considerably less common than those of the posterior urethra. Here in we report a case of anterior urethral polyps in a child with brief review of the literature.
Child* ; Humans ; Male ; Polyps* ; Urethra ; Urethral Obstruction

Benign prostatic hyperplasia and urethral stricture are common causes of urethral obstruction over 50 years of age. To evaluate the usefulness of the Gianturco expandable stent for dilatation of the urethra, 14 single stents were placed in the posterior urethra (2 in prostatic urethra, 12 in membranous urethra), 20 in the anterior urethra. And 4 six-eight connected stents ere positioned in the posterior urethra to straddle at the internal sphincter or external sphincter and followed up for 2 weeks (one dog), 1 month (two dog), 2 months (one dog), 3 months (one dog), 5 months (one dog), 9 months (three dogs), and 14 months (two dogs). Seven of 18 stents in the posterior urethra and 5 to 20 in the anterior urethra were migrated during the follow-up. By 2 weeks after placement. 100% expansion was achieved in the posterior urethra, but by 1 month in the anterior urethra. Partial or complete epithelial covering of the stents was observed 1 month after stent placement in the anterior urethra, but mucosal folds were observed in the anterior and posterior urethra. Urinary incontinence was not observed in all cases. Our experience suggests that Gianturco expandable stent can be used in dilating and maintaining the lumen of the prostatic urethra and urethral stricture.
Animals ; Dilatation ; Dogs* ; Follow-Up Studies ; Prostatic Hyperplasia ; Stents* ; Urethra* ; Urethral Obstruction ; Urethral Stricture ; Urinary Incontinence

PURPOSE: Urethrocutaneous fistulas and urethral strictures are the most frequent complications after hypospadias repair. We reviewed outcomes after surgical repair of these complications to evaluate the factors determining successful outcome. MATERIALS AND METHODS: In 60 patients with fistula or stricture after hypospadias repair performed between September 1993 and January 2008, we reviewed incidences, clinical features, and outcome after repair with respect to initial hypospadias types. RESULTS: Fistulas were observed in 42 patients and were surgically repaired in 39 (92.8%). In 8 (19.0%) and 3 (7.1%) patients, concurrent meatal and urethral strictures were noted, respectively. The number of fistulas was single in 38 (90.5%) and 2 in 4 (9.5%) patients. Fistulas occurred most frequently from the penoscrotal type hypospadias (22/65, 33.8%) and had initially undergone transverse preputial island flap repair (13/26, 50%). Complete excision of the fistulous tract and multilayer advancement flap closure was the most common method for fistula repair (24), followed by cross-suture in 9 and repeat urethroplasty in 6. Initial management was successful in 35 (89.7%) patients. Urethral strictures were observed in 16 patients with equal incidences at the meatus and the other portion of the urethra. Successful outcome was achieved in all metal stenosis after repeat meatoplasty, whereas for urethral strictures, 4 (20%) patients who underwent visual urethrotomy experienced recurrent strictures. CONCLUSIONS: Urethrocutaneous fistulas can be successfully repaired by complete excision and cross-suture closure and multiple coverage with healthy tissues. In urethral strictures, reconstruction of ample neo-meatus is the key to achieving sufficient stream regardless of the stricture site.
Constriction, Pathologic ; Female ; Fistula ; Humans ; Hypospadias ; Incidence ; Male ; Rivers ; Urethra ; Urethral Obstruction ; Urethral Stricture

We describe the use of gold-coating expandable urethral stents implanted into 3 patients with urinary obstruction due to recurrent urethral stricture(one case) and inoperable benign prostatic hypertrophy(two cases) respectively. The stent formed from stainless steel in the form of a cylindrical zigzag pattern and coated with 24 carat gold was inserted via delivering device using fluoroscopy control under heal anesthesia. During 6 months follow-up. the stents remained in situ and there were no urinary incontinence or other complication. The maximum flow rate were 24ml/sec in case of urethral stricture and 20ml/sec in BPH. These patients were satisfied with the procedure which provided a quiet safe and effective alternative to conventional surgical treatment.
Anesthesia ; Fluoroscopy ; Follow-Up Studies ; Humans ; Stainless Steel ; Stents* ; Urethral Obstruction* ; Urethral Stricture ; Urinary Incontinence

No abstract available.
Humans ; Lower Urinary Tract Symptoms* ; Prostate* ; Urethral Obstruction*

Most of anti-incontinence surgeries bear the risk of postoperative complication such as voiding dysfunction due to urethral obstruction. Fortunately, Tension Free Vaginal Tape(TVT) procedure has much lower incidence of postoperative urethral obstruction than other surgical procedures for stress urinary incontinence. There are many reports about the surgical treatments for short-term urethral obstruction after TVT procedure. However, there are few reports on the effect of surgical releasing of the obstruction lasting for a long period. In our case, the patient had urethral obstruction for 32 months after TVT procedure and she was able to void well after surgical releasing of the tape. We suggest that releasing of the tape will be a treatment of choice for long-term urethral obstruction after TVT procedure.
Humans ; Incidence ; Postoperative Complications ; Suburethral Slings* ; Urethral Obstruction* ; Urinary Incontinence

We report our experience with a case of urethrolysis using a transvaginal suprameatal approach without lateral perforation of the urethropelvic ligament. A 43-year-old woman suffered from voiding difficulties such as hesitancy, frequency, urgency, decreased urinary flow, residual urine sensation after Marshall-Marchetti-Krantz operation concurrent with hysterectomy. The results of multidisciplinary work-ups of urethral obstruction such as history, vaginal examination, voiding cystourethrography, urodynamic study, showed that she had urethral obstruction due to a previous operation. Since clean intermittent catheterization and alpha-blocker therapy did not improve her symptoms, suprameatal transvaginal urethrolysis was performed to resolve the symptoms. Postoperative follow-up for 5 months showed that the patient remained free from voiding difficulty in their life. We believe that suprameatal transvaginal urethrolysis is worth attempting for urethral obstruction associated with anti-incontinence surgery.
Adult ; Female ; Follow-Up Studies ; Gynecological Examination ; Humans ; Hysterectomy ; Intermittent Urethral Catheterization ; Ligaments ; Sensation ; Urethral Obstruction* ; Urodynamics

We reviewed our experience retrospectively with 65 patients who had post-traumatic complete urethral stricture secondary to pelvic bone fracture or other causes during last 10 years. All patients underwent delayed endoscopic internal urethrotomy (EIU) 3 to 9 months later after immediate suprapubic diversion. Prior to EIU, the antegrade-retrograde urethrogram demonstrated a complete urethral disruption, and the length of urethral obstruction was measured from 0.5cm to 3.5cm (mean 1.4cm). Of 65 patients, 61 patients (94%) had successful operations, 4 patients (6%) whose strictures were measured more than 2.5cm were failed and treated with open urethroplasty. Sixty-one patients who eventually underwent successful endoscopic internal urethrotomy; 28 patients (46%) achieved satisfactory urethral voiding after first EIU; 33 patients (54%) took operations more than twice due to recurred partial urethral stricture. After 6 to 53 months (average-21months), fifty-six (86%) of 65 patients voided satisfactorily (incontinence in 3 patients). Five patients who did not void well even after successful EIU were diagnosed to have neurogenic bladder (detrusor areflexia). Of 65 patients, 16 patients (25%) had post-traumatic impotence. After the EIUs were performed, there were no newly developed impotences. There were no serious major complications. We concluded that direct visual internal urethrotomy was useful and safe as a primary minimally invasive therapeutic modality for post-traumatic complete urethral stricture in selected patients with relatively short urethral defect (less than 2.5cm).
Constriction, Pathologic ; Erectile Dysfunction ; Humans ; Male ; Pelvic Bones ; Retrospective Studies ; Urethral Obstruction ; Urethral Stricture* ; Urinary Bladder, Neurogenic