932 IS REPEATED DIRECT VISION INTERNAL URETHROTOMY FEASIBLE IN THE MANAGEMENT OF RECURRENT URETHRAL STRICTURES?

Abstract

You have accessJournal of UrologyPenis/Testis/Urethra: Benign & Malignant Disease III1 Apr 2012932 IS REPEATED DIRECT VISION INTERNAL URETHROTOMY FEASIBLE IN THE MANAGEMENT OF RECURRENT URETHRAL STRICTURES? Josh W.T. Kao, Chih-Chieh Lin, Alex Tong-long Lin, and Kuang Kuo Chen Josh W.T. KaoJosh W.T. Kao Taipei, Taiwan More articles by this author , Chih-Chieh LinChih-Chieh Lin Taipei, Taiwan More articles by this author , Alex Tong-long LinAlex Tong-long Lin Taipei, Taiwan More articles by this author , and Kuang Kuo ChenKuang Kuo Chen Taipei, Taiwan More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.1029AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES We evaluated the success rate of direct vision internal urethrotomy (optic urethrotomy) as a treatment for recurrent male urethral strictures and to compare the outcomes of management in different causes of urethra stricture. METHODS A retrospective chart review was performed on 273 male patients who underwent repeated urethrotomy (more than once) from January 2001 through August 2010. We collected the data of patients, including gender, age, etiology of urethra structure, position of urethra stricture, underlining disease, unset of urethra stricture. The Kaplan-Meier method was used to analyze stricture-free probability after the first, second, third, fourth and fifth urethrotomy. RESULTS Data were available for 150 patients. All patients are male. Mean patient age was 74.3 years old (range 33 to 92). All patients received more than once urethrotomy. The leading cause of urethral stricture was surgical related (84 %). The occurring site of strictures (n=150) were respectively in the bulbar urethra (n=86), penile urethra (n=28), penile bulbar urethra (n=20), fossa navicularis (n=16). Overall mean follow-up period was 9 months (range 8 ∼ 204). The first onset of urethral stricture was about 8 months after surgical procedure in the surgical related group. The stricture-free rate after each urethrotomy was 2nd 53%, 3rd 40%, 4th 39%, and 5th 18%, respectively. The median period of each surgery to receive next urethrotomy was 2nd 22.5, 3rd 16.1, 4th 17.9, and 5th 10.2 months, respectively. CONCLUSIONS In our series, most urethral disease resulted from catheterization or instrumentation. Repeated urethrotomy seemed to be more effective than we expected. But there were still 20% failure rate after repeated surgery. It has been suggested that urethroplasty has a higher success rate in patients with recurrent stricture. However, in elderly patients and poor surgery candidate with a limited life expectancy, repeated urethrotomies or may be useful to achieve the goal for urethroplasty. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e379 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Josh W.T. Kao Taipei, Taiwan More articles by this author Chih-Chieh Lin Taipei, Taiwan More articles by this author Alex Tong-long Lin Taipei, Taiwan More articles by this author Kuang Kuo Chen Taipei, Taiwan More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...