We reviewed retrospectively the results in 39 patients who underwent endoscopic urethrotomy during two years 1/1998-12/1999. The results were good; most of patients could void easily. The time of operation was short and patients experienced few complications. Only 3 patients had hematuria, no need for transfusion. The time the catheter remainly depends on the character of the stricture
Urethral Stricture ; therapeutics ; surgery

A retrospective study on 28 patients with urethral stricture in Saint Paul during 1998-1999 was carried out of which 12 patients treated by the intraurethral incision. The results after 3 years of the operation have shown that good outcome (8), medium outcome (3) and poor outcome (1). The intraurethral incision can not substitute the reconstructive surgery in cases of complete and long urethral stricture. It only reduced the rate of reconstructive surgery
Urethral Stricture ; therapeutics ; surgery

BACKGROUNDIn order to improve the clinical treatment level of urinary system injury, it is necessary to build up an animal model of urinary system wound, which is not only analogous to real clinical practice, but also simple and practical.

METHODSWe have developed the third generation of firearm fragment wound generator based on the first and the second producer. The best explosive charge of the blank cartridge was selected by gradient powder loading experiments. The firearm fragment injuries were made to the bulbous urethra of 10 New Zealand male rabbits. One week preoperatively and 2, 4 and 8 weeks postoperatively, all the animals underwent urethroscopy and urethrography. At 2, 4 and 8 weeks postoperatively, two animals were randomly selected and killed, and the urethra was cut off for pathological examination.

RESULTSThe shooting distance of the third generation of firearm fragment wound generator is 2 cm. The best explosive charge of the blank cartridge is 1 g of nitrocotton. All rabbits survived the procedures and stayed alive until they were killed. Injuries were limited to bulbous urethra and distal urethra. Round damaged areas, 1-1.5 cm in length, on the ventral wall were observed. Ureteroscopy results showed that canal diameter gradually shrank by over 50% in 9 rabbits. The rate of success was 90%. Urethrography result noted that a 1-1.3 cm stricture was formed at the bulbous urethra. Histology results of injured stricture urethra showed that fibrous connective tissue hyperplasia and hyaline degeneration caused further stricture in the canal.

CONCLUSIONSThe third generation of firearm fragment wound generator imitates the bullet firing process and is more accurate and repeatable. The corresponding rabbit model of traumatic complex urethral stricture simulates the real complex clinical conditions. This animal model provides a standardized platform for clinical researches on treating traumatic injuries to the urinary system.

Animals ; Disease Models, Animal ; Male ; Penis ; surgery ; Rabbits ; Urethra ; surgery ; Urethral Stricture ; surgery

OBJECTIVETo study the clinical value and operation skills of nasal endoscopy-assisted bulboprostatic anastomosis in the treatment of posterior urethral stricture.

METHODSBetween January 2012 and November 2014, we performed nasal endoscopy-assisted bulboprostatic anastomosis for 12 male patients with posterior urethral stricture. We recorded the operation time, blood loss, exposure of operation visual field, and success rate of anastomosis and summarized the operation skills.

RESULTSEight of the patients experienced first-stage recovery. Two underwent a urethral dilation at 3 months postoperatively, 1 received 10 urethral dilations within 5 months after surgery, and 1 underwent internal urethrotomy after failure in urethral dilation, but all the 4 cases were cured.

CONCLUSIONNasal endoscopy can significantly improve the operation field exposure, elevate the precision, reduce the difficulty, and enhance the efficiency of bulboprostatic anastomosis in the treatment of posterior urethral stricture.

Anastomosis, Surgical ; Endoscopy ; Humans ; Male ; Operative Time ; Postoperative Period ; Urethra ; pathology ; surgery ; Urethral Stricture ; surgery

OBJECTIVETo investigate the effect of free internal prepuce lamina patch urethroplasty on long-segment urethral stricture.

METHODSEight patients of long-segment urethral stricture underwent resection of atresia posterior urethra and/or incision of stricture anterior urethra, free internal prepuce lamina patch as of corresponding length and width were taken for the reconstruction of the urethra, and mean while multi-hole silica ge tract was placed in the urethra.

RESULTSMiction was easy and fluent in 7 cases, and unobstructed in 1 case after two urethral soundings.

CONCLUSIONFree internal prepuce lamina patch urethroplasty was a good method for treating long-segment urethral stricture.

Adult ; Humans ; Male ; Middle Aged ; Urethra ; surgery ; Urethral Stricture ; surgery ; Urologic Surgical Procedures, Male ; methods

Advances in urogenital plastic surgical tissue transfer techniques have enabled urethral reconstruction surgery to become the new gold-standard for treatment of refractory urethral stricture disease. Questions remain, however, regarding the long-term implications on sexual function after major genital reconstructive surgery. In this article, we review the pathologic features of urethral stricture disease and urologic trauma that may affect erectile function (EF) and assess the impact of various specific contemporary urethroplasty surgical techniques on male sexual function.
Erectile Dysfunction ; Humans ; Male ; Reconstructive Surgical Procedures ; methods ; Urethra ; surgery ; Urethral Stricture ; physiopathology ; surgery

BACKGROUNDEndoscopic treatment for urethral stricture, including cold knife and laser, poses a major challenge to clinical practice. Both the benefits and drawbacks of these two treatments remain controversial. This article aimed to compare the efficacy and safety of laser and cold knife urethrotomy for urethral stricture.

METHODSWe searched PubMed (1966 - 2009), Embase (1980 - 2009), Cochrane Central Register of Controlled Trials (CCRCT, 2009 No.1) and Chinese Biomedical Literature Database (CBM) for laser and cold knife urethrotomy as treatment for male urethral stenosis, looking in the English literatures. Two reviewers independently screened the literatures and extracted information. Chi-square test was used for statistical analysis with SPSS15.0.

RESULTSA total of 44 articles, including of 3230 cases was retrieved. Success rate of patients treated with laser was 74.9% compared with 68.5% for cold knife, with very similar clinical results despite a statistically significant difference (P = 0.004). The trend in success rate at a different follow-up time was similar between the two groups. No significant difference in success rate was found between the groups of repeat operation for recurrence cases, first P = 0.090 and second P = 0.459. The shorter the stricture length was (< 1 cm), the higher the success rate was (P < 0.0001). No significant difference in success rate between the laser and cold knife groups was found in neither bulbar nor membranous urethra, bulbar P = 0.660 and membranous P = 0.477. The rates of urinary incontinence, urinary extravasation, and urinary tract infection showed no significant difference (P = 0.259, P = 0.938, P = 0.653, respectively).

CONCLUSIONSSuccess rates for laser and cold knife were very similar despite being statistically different, with the groups having a similar trend in success rates at different follow-up time. Stricture location and history of endoscopic intervention did impact treatment outcome but was not significantly different. The two groups showed no significant difference in major complications.

Endoscopy ; Humans ; Laser Therapy ; methods ; Male ; Treatment Outcome ; Urethra ; surgery ; Urethral Stricture ; surgery

OBJECTIVETo discuss the methods for urethral external meatus and glanuloplasty after correction of hypospadias.

METHODSThe V shape flap on the dorsal side of glan, combined with the bilateral glan flaps were moved to the ventral side. The flap at the ventral side of urethral external meatus was turned over. Then the urethral external meatus was repositioned to the top end of glan with the ventral defects covered by the dorsal flaps. Then the coniform glan was reconstructed.

RESULTSFrom January 2008 to December 2013, 28 cases were treated, including glandular hypospadias, postoperative retraction of external urethral meatus and meatal stenosis. 21 patients were followed up for 1 -12 months (average, 1 month) with marked improvement of glan appearance and retraction of external meatus. No meatal stenosis happened.

CONCLUSIONSPostoperative retraction of urethral external meatus and meatal stenosis can be corrected by V shape flap on the dorsal side of glan combined with the bilateral glan flaps. The flat appearance of glan can be improved. It is an ideal method for glandular hypospadias.

Humans ; Hypospadias ; surgery ; Male ; Penis ; surgery ; Postoperative Complications ; surgery ; Postoperative Period ; Surgical Flaps ; Urethra ; surgery ; Urethral Stricture ; etiology ; surgery

OBJECTIVETo explore the treatment of urethral stricture.

METHODSWe retrospectively studied the clinical data of 1 case of long anterior urethral stricture treated by urethroplasty with pedunculated preputial flap and testicular tunica vaginalis, and summarized the treatment of the disease with review of the relevant literature.

RESULTSThe operation was smooth and successful, and no such complications as fistula and urethral stricture were found during the follow-up.

CONCLUSIONUrethroplasty with pedunculated preputial flap and testicular tunica vaginalis as a substitute is feasible for the treatment of urethral stricture. The key to a successful operation is the proper choice of a urethral substitute.

Adult ; Foreskin ; transplantation ; Humans ; Male ; Skin Transplantation ; Surgical Flaps ; Testis ; Urethral Stricture ; surgery

Recently, the authors had an opportunity to treat a 73-year-old male patient who was transferred to our institution with problematic multiple strictures of the anterior urethra subsequent to a suprapubic cystostomy. A proximal urethra was reconstructed with scrotal skin, but due to the shortage of distal skin, as a last resort we reconstructed a distal urethra using a polytetrafluoroethylene graft in place of 10 cm long urethral strictures. About 5 months after surgery, we had to reexplore the polytetrafluoroethylene graft area because of pain and found, much to our surprise, that the urethra had been completely regenerated around the length of polytetrafluoroethylene graft which now remained freely detached in the urethral canal. Following removal of the polytetrafluoroethylene graft, the patient could urinate normally and was subsequently discharged without further problems. We concluded that this case was incidentally successful with good regeneration of urethral mucosa of the anterior urethra by grafting a polytetrafluoroethylene tube.
Aged ; Case Report ; Human ; Male ; Polytetrafluoroethylene ; *Prostheses and Implants ; Regeneration ; Urethra/physiopathology ; Urethral Stricture/physiopathology/*surgery