Outcomes Of Endoscopic Urethrotomy and Urethroplasty On Uretheral Strictures
DOI:
https://doi.org/10.63682/jns.v14i32S.8224Keywords:
Urethroplasty, Endoscopic urethrotomy, Uretheral strictures, Recurrence, SuccessAbstract
Background: A small percentage of males get urethral stricture. As a first line of defence, urethrotomy is performed. A little over half of the strictures come back within four years. Repeat urethrotomy or open urethroplasty are two options for further therapy.
Objective: The purpose of this research is to find out how well endoscopic urethrotomy and urethroplasty work for treating uretheral strictures.
Methods: This retrospective analysis included 110 male patients underwent for uretheral stricture. Group I had 55 patients who got urethroplasty, whereas group II had 55 who received endoscopic urethrotomy. All patients in both groups were followed for 4-6 months. Both groups were compared for post-treatment success and complications. All data was analysed with SPSS 24.0.
Results: The mean age of the patients in group I was 47.18±6.53 years and in group II was 50.14±11.78 years.Most common symptoms were dysuria, urinary retention and pollakiuria among both groups. Infection was the most common cause followed by urethral trauma. Membranous urethra strictures were most prevalent. A substantial difference in Q max flowmetry was seen between the two techniques after surgery (p-value <0.05). Postoperative success rate was higher in group I compared to group II (p < 0.004). Group II 11 (20%) had a greater recurrence rate than group I 4 (7.3%).
Conclusion: In this study, we determined that urethroplasty is a safer and more effective procedure than endoscopic urethrotomy. Additionally, urethroplasty results in increased urine flow and an incidence of recurrence that is lower
Downloads
Metrics
References
Verla, W., Oosterlinck, W., Spinoit, A.F. and Waterloos, M. (2019) A Comprehensive Review Emphasizing Anatomy, Etiology, Diagnosis, and Treatment of Male Urethral Stricture Disease. BioMed Research International, 2019, Article ID: 9046430. https://doi.org/10.1155/2019/9046430
Shoukry, A.I., Abouela, W.N., ElSheemy, M.S., Shouman, A.M., Daw, K., Hussein, A.A., et al. (2016) Use of Holmium Laser for Urethral Strictures in Pediatrics: A Prospective Study. Journal of Pediatric Urology, 12, 42.E1-42.E6.
https://doi.org/10.1016/j.jpurol.2015.06.016
Whybrow P, Rapley T, Pickard R, Hrisos S. How men manage bulbar urethral stricture by concealing urinary symptoms. Qual Health Res. 2015;25:1435–42.
Stephenson R, Carnell S, Johnson N, et al. Open urethroplasty versus endoscopic urethrotomy - clarifying the management of men with recurrent urethral stricture (the OPEN trial): study protocol for a randomised controlled trial. Trials 2015; 16: 600.
Shen, J., Vale, L., Goulao, B. et al. Endoscopic urethrotomy versus open urethroplasty for men with bulbar urethral stricture: the OPEN randomised trial cost-effectiveness analysis. BMC Urol 21, 76 (2021). https://doi.org/10.1186/s12894-021-00836-1
MacDonald S, Haddad D, Choi A, Colaco M, Terlecki R. Anterior urethroplasty has transitioned to an outpatient procedure without serious rise in complications: data from the national surgical quality improvement program. Urology. 2017;102:225–8.
Devlin NJ, Shah KK, Feng Y, Mulhern B, van Hout B. Valuing health-related quality of life: an EQ-5D-5L value set for England. Health Econ. 2018;2018:7–22
Goulao B, Carnell S, Shen J, et al. Surgical treatment for recurrent bulbar urethral stricture: A randomised open label superiority trial of open urethroplasty versus endoscopic urethrotomy (The OPEN Trial). European Urology. E-pub ahead of print-4 Jul 2020
Chapple C, Andrich D, Atala A, et al. SIU/ICUD consultation on urethral strictures: the management of anterior urethral stricture disease using substitution urethroplasty. Urology. 2014;83(Suppl. 3):31–47. https://doi.org/10.1016/j.urology.2013.09.012.
Yameogo, C., Ouattara, A., Kaboré, F., Ky, B., Bougayiri, A., Traoré, O., et al. (2017) Male Anterior Urethral Stricture: Epidemiological Profile and Management at Ouagadougou University Teaching Hospital (Burkina-Faso). Open Journal of Urology, 7, 196-206.https://doi.org/10.4236/oju.2017.71102
Isen, K. and Nalçacıoğlu, V. (2015) Direct Vision Internal Urethrotomy by Using Endoscopic Scissors. International Urology and Nephrology, 47, 905-908.
https://doi.org/10.1007/s11255-015-0960-x
Micheli E, Ranieri A, Peracchia G, et al. End-to-end urethroplasty: Long-term results. BJU Int2002;90:68-71. http://dx.doi.org/10.1046/j.1464-410X.2002.02832.x
Barbagli G, Sansalone S, Djinovic R, et al. Current controversies in reconstructive surgery of the anterior urethra: A clinical overview. IntBraz J Urol2012;38:307-16. http://dx.doi.org/10.1590/S1677-55382012000300003
Wong SSW, Aboumarzouk OM, Narahari R, O’Riordan A, Pickard R. Simple urethral dilatation, endoscopic urethrotomy, and urethroplasty for urethral stricture disease in adult men. Cochrane Database Syst Rev. 2012;12:CD006934. doi:10.1002/14651858.CD006934.pub3.
Goulao B, Carnell S, Shen J, et al. Surgical treatment for recurrent bulbar urethral stricture: A randomised open label superiority trial of open urethroplasty versus endoscopic urethrotomy (The OPEN Trial). European Urology. E-pub ahead of print-4 Jul 2020
Barbagli G, Palminteri E, Lazzeri M, et al. Long-term outcome of urethroplasty after failed urethrotomy versus primary repair. J Urol. 2019;165:1918–9. doi: 10.1016/S0022-5347(05)66242-8
Singh O, Gupta SS, Arvind NK. Anterior urethral strictures: A brief review of the current surgical treatment. Urol Int. 2011;86:1–10. doi: 10.1159/000319501.
Santucci RA, McAninch JW, Mario LA, et al. Urethroplasty in patients older than 65 years: Indications, results, outcomes and suggested treatment modifications. J Urol. 2004;172:201–3. doi: 10.1097/01.ju.0000128810.86535.be
Heyns CF, Van der Merwe J, Basson J, et al. Treatment of male urethral strictures – possible reasons for the use of repeated dilatation or internal urethrotomy rather than urethroplasty. S Afr J Surg. 2012;50:82–7. doi: 10.7196/sajs.1081
Anger JT, Santucci R, Grossberg AL, et al. The morbidity of urethral stricture disease among male medicare beneficiaries. BMC Urol. 2010;10:3. doi: 10.1186/1471-2490-10-3
Noorshad Khan, Asif Khan, Mohammad Rashidullah, Sami Ur Rahman, Ghufranullah, Tausif Ahmad. (2022). Outcomes of Uretheral Strictures Treated with Endoscopic Urethrotomy and Urethroplasty. Pakistan Journal of Medical & Health Sciences, 16(03), 1171. https://doi.org/10.53350/pjmhs221631171
Munks, D.G, Alli, M.O. and Goad, E.H. (2010) Optical Urethrotomy under Local Anaesthesia Is a Feasible Option in Urethral Stricture Disease. Tropical Doctor, 40, 31-32.https://doi.org/10.1258/td.2009.090121
Erickson, B. ∙ Breyer, B. ∙ McAninch, J.Changes in uroflowmetry maximum flow rates after urethral reconstructive surgery as a means to predict for stricture recurrence.J Urol. 2013; 186:1934-1937
Payne, S. ∙ Fowler, S. ∙ Mundy, A.Analysis of a 7-year national online audit of the management of open reconstructive urethral surgery in men.BJU Int. 2020; 125:304-313
Whybrow, P ∙ Pickard, R ∙ Hrisos, S .Equipoise across the patient population: optimising recruitment to a randomised controlled trial.Trials. 2017; 18:1-12
Wessells, H. ∙ Angermeier, K.W. ∙ Elliott, S.Male urethral stricture: American Urological Association Guideline.J Urol. 2017; 197:182-190
Downloads
Published
How to Cite
Issue
Section
License
This work is licensed under a Creative Commons Attribution 4.0 International License.
You are free to:
- Share — copy and redistribute the material in any medium or format
- Adapt — remix, transform, and build upon the material for any purpose, even commercially.
Terms:
- Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
- No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
