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At least 145 records · Page 8Linked to original sources
PubMed1982

Urethral strictures following transurethral resection of posterior urethral valves.

Dense urethral strictures developed in 3 of 36 patients (8 per cent) following transurethral fulguration of posterior urethral valves. Common potential etiologies include the use of a loop resectoscope, large size of the valves and immediate supravesical diversion. The latter results in a "dry" urethra and the strictures that resulted may be analogous to the stenosis seen following a "dry" ureteral reimplant. Techniques to maintain flow through the urethra after resection and the avoidance of an extensive resection may be helpful in preventing urethral strictures.

Electrocoagulation↗
PubMed1980

Micturitional static urethral pressure profile: a method of recording urethral pressure profile during voiding and the implications.

Using a tri-lumen graduated 10F catheter we attempted to record static (lateral) pressures at successive points in the urethra, synchronous with intravesical pressure recorded during voiding. Based on our understanding of the essential physical principles described by many earlier investigators we attempted numerous studies in a predominantly male population, which included normal male and female subjects, and male subjects with bladder outlet obstruction of varied etiology. We also attempted to evaluate the effects of the Valsalva maneuver, augmenting the detrusor contraction and artificial distal obstruction (penile compression) on the micturitional static urethral pressure profiles. Studies also were performed to compare the static urethral pressure profiles obtained with the anterograde (catheter withdrawal) and with the retrograde (catheter insertion during voiding) techniques. All of these studies have helped in understanding the various factors, such as double obstructions, artifactual catheter obstructions and incompetent distal sphincter mechanisms, in the interpretation of the micturitional static urethral pressure profile.

Adult↗
PubMed1996

A self-expanding, self-retaining temporary urethral stent (Urocoil(TM)) in the treatment of recurrent urethral strictures: preliminary results.

OBJECTIVE: To determine the efficacy of a self-expanding self-retaining temporary urethral stent (Urocoil) in patients with recurrent urethral strictures at different levels in the urethra. PATIENTS AND METHODS: Urocoil stents were placed in 18 patients (mean age 42 years, range 28-60) with recurrent urethral strictures. The stents were left for a mean of 8 months (range 6-14) and patients followed for a mean of 9 months (range 6-18) after removal of the stent, being assessed by urine culture, urethrography, flexible cystoscopy and urinary flow rate. RESULTS: The stents were easy to insert and remove under local anaesthesia. All patients except one had a satisfactory outcome. Complications included stent migration (3), encrustation (2), hyperplasia of the mucosa (2) and the one failure, where the stent was extruded by a long fibrous stricture. CONCLUSION: The use of the temporary stent is an encouraging development in the treatment of this complicated problem but a longer follow-up is necessary to exclude the possibility of late recurrence.

Adult↗
PubMed1996

Endourethrotomy of posterior urethral obliterations and severe strictures: improved outcome with urethral self-dilatation.

Eighteen male patients underwent endoscopic management of urethral obliterations and severe strictures of the subprostatic urethra. Thirteen patients who performed clean urethral self-dilatation after endoscopic repair had a lower incidence of recurrent strictures (P = 0.03) and required fewer visual internal urethrotomies than the initial five patients, who did not self-dilate (P = 0.01). All patients had minimal morbidity and required short hospitalization to achieve adequate urine flow and a stable urethral neolumen during the follow-up period.

Adolescent↗
PubMed1998

A bioabsorbable self-expandable, self-reinforced poly-l-lactic acid urethral stent for recurrent urethral strictures: a preliminary report.

PURPOSE: We studied whether a new bioabsorbable self-expandable, self-retaining and self-reinforced poly-l-lactic acid double spiral stent is able to prevent the edges of a cut recurrent urethral stricture from adhering together and the scar from shrinking, thus obviating stricture recurrence. MATERIALS AND METHODS: A bioabsorbable spiral stent was inserted into the stricture site in the urethra immediately after optical urethrotomy in 22 patients with recurrent urethral stricture. Uroflowmetry, measurement of residual urine volume, urine culture and urethroscopy were performed before and 1, 3, 6 and 12 months after optical urethrotomy. RESULTS: All 22 patients voided freely on day 1 or 2 after urethrotomy. The stent slipped partially proximal to the stricture and had to be changed in only 1 patient. The stent was totally epithelialized in all but 1 patient at 6 months and had degraded in all at 12 months. The improvement in flow rate was maintained during followup except in 10 patients with stricture recurrence, which was outside the stent area usually close to the external sphincter in 7 and in the stent area in 3. All recurrences were treated with repeat optical urethrotomy and a new stent was inserted. Urinary infections developed in 2 patients and were successfully treated with oral antibiotics. CONCLUSIONS: The self-expandable self-reinforced poly-l-lactic acid double spiral stent is a promising new method in the treatment of recurrent urethral strictures. There is no need to remove the device and no foreign material remains in the urethra. However, longer followup and controlled studies are needed to evaluate all benefits and side effects of this new treatment modality.

Absorbable Implants↗
PubMed2005

Infection-induced urethral defect treated by urethral reconstruction with a radial forearm flap.

Abstract A 47-year-old man was admitted with the chief complaint of a urethral defect. An approximately 17-cm defect of the urethra seemed to have been occurred by the infection of implanted foreign bodies in the penile skin. Reconstruction of the urethra and the ventral skin was performed with a free radial forearm flap. A fistula formed at the proximal anastomosis after the operation, but was controlled conservatively. Urethral stricture at the proximal anastomosis subsequently developed. A urethral stent made of shape memory alloy was placed with the preservation of voiding function.

Forearm↗
PubMed1994

Congenital urethral obstruction: Cobb's collar or prolapsed congenital obstructive posterior urethral membrane (COPUM).

OBJECTIVE: To determine whether there are two distinct types of congenital obstruction of the proximal urethra. PATIENTS AND METHODS: Three boys with a congenital bulbar urethral narrowing (Cobb's collar) were examined. Recent papers on congenital obstructive posterior urethral membrane (COPUM) were reviewed. RESULTS: The more proximal lesion is a membranous obstruction which is able to prolapse as far as the bulbar urethra, but has paramedian folds that attach along the posterior wall of the urethra to the verumontanum, and is due to persistence of an embryological attachment between the distal verumontanum and the anterior wall of the posterior urethra. The more distal narrowing is not always obstructive and is primarily a bulbar urethral membrane, is independent of the verumontanum and external sphincter, and may represent a persistence of part of the urogenital membrane. CONCLUSIONS: There are two distinct types of congenital obstruction of the proximal urethra, with the association to the verumontanum being the distinguishing feature.

Child↗
PubMed1991

[Detection of Chlamydia trachomatis from urethral swab in male urethritis by polymerase chain reaction].

A polymerase chain reaction (PCR) with Chlamydia trachomatis-specific primers was applied for detection of C. trachomatis from urethral swab in male urethritis. The results were compared with those of culture method for detection of C. trachomatis. Of 18 clinical specimens tested in this study, inclusion bodies of C. trachomatis were detected in 11 specimens by the culture method. For PCR, sample DNA was prepared from transport medium in which urethral smear was suspended and two oligonucleotides based on sequences within the major outer membrane protein gene from C. trachomatis serovar L2 were used as extension primers. In 12 of the 18 specimens, 242bp DNA fragment was amplified by PCR and demonstrated to be the DNA fragment of C. trachomatis by Southern blot hybridization. No DNA of 242bp was amplified by PCR from five specimens in which any inclusion bodies of C. trachomatis were observed or from a specimen in which one inclusion body per cover slip was detected by culture method. C. trachomatis DNA of 242bp was amplified from all specimens in which 14 and more inclusion bodies per cover slip were detected by culture method. In two specimens concluded s negative by culture method, amplified C. trachomatis DNA were detected by PCR. Thus, the PCR would be a more simple and sensitive method for detection of C. trachomatis, compared with the culture method.

Bacteriological Techniques↗
PubMed1989

A case of urethral replacement with polytetrafluoro-ethylene graft for multiple anterior urethral strictures.

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↗
PubMed2006

[Prevention of urethral stricture after transurethral vaporesection of prostate by adjustable urethral tractor].

OBJECTIVE: To reduce the complication by transurethral vaporesection of prostate (TUVP) using adjustable urethral tractor. METHODS: One hundred and six cases with benign prostate hypertrophy underwent TUVP and catheter traction after operation by an adjustable tractor. The results by catheter traction were compared with those by rubberized cloth paste and carbasus compression. RESULT: The urethral stricture occurred in 2.7%, 6.7%, 30.4% of cases by the catheter traction, rubberized cloth paste and carbasus compression respectively, which had statistical significance (P <0.01). CONCLUSION: The incidence of urethral stricture can be reduced by catheter traction after TUVP.

Aged↗
PubMed1976

Infection of a nonspecific urethritis patient and his consort with a pathogenic species of nonspecific urethritis Corynebacteria, Corynebacterium genitalium, N. SP.

A patient with nonspecific urethritis (NSU) and his consort were examined for infection with NSU corynebacteria, mycoplasmas, and gonococci. No classic and T-mycoplasmas or gonococci were cultured, but one species of NSU corynebacteria was isolated not only from the patient's urethral discharge during three episodes of NSU but also from his consort. It was not isolated after successful treatment of the patient with tetracycline and the use of condoms prevented reoccurrence of urethritis. This NSU corynebacterium was isolated previously from one epididymitis patient and two NSU patients but not from any of the normal male and female subjects examined. Therefore, this strain is considered to be one of the etiologic agents of NSU and female subjects are asymptomatic carriers. In consequence, it is suggested that NSU corynebacteria which are commensals and pathogens of the male and female urogenital tracts should be incorporated in a new species, of the Coryneform group, and that this strain should be the type species, Corynebacterium genitalium n. sp.

Adult↗
PubMed1992

[Urethral sonography in the diagnosis and preoperative evaluation of urethral stenosis].

An area of spongiofibrosis can be found proximal and distal to all stenosis of the urethra. The severity of such spongiofibrosis as well as its length are in many instances decisive when choosing an adequate surgical approach. Conventional radiological diagnosis of stenosis of the urethra only shows the area of urethral stricture but is unable to inform on the fibrosis of the spongy body. Sonourethrography or urethral echography affords a dynamic tridimensional examination of the anterior urethra which provides accurate data on the length of the stenosis, as well as the extend and severity of the spongiofribosis. Sixteen patients diagnosed with stenosis of the urethra through sonourethrography were evaluated. This easy-to-perform investigation, allowed the identification of 4 patients with peristenotic intense spongiofibrosis, hypercongenital urethra, who underwent open urethroplastia. The urethra of another 3 patients showed normal echogenicity, but diminished elasticity, and were diagnosed as of moderate spongiofibrosis requiring extensive internal urethrotomy. We believe sonourethrography should become a procedure to be included as part of the routine pre-surgical investigation of the stenosis of the urethra due to its non-invasive nature, easiness to perform, and because it provides highly useful information which would allow a decreased number of re-stenosis following surgery of the urethral stenosis.

Fibrosis↗
PubMed2005

Urethral reconstruction using buccal mucosa urethroplasty in the treatment of urethral injury.

A 52-year-old Japanese man was referred to us with a urethral injury caused by masturbation. His penis was swollen and about one and a half times its size due to urine extravasation and infection. Foreign bodies were surgically removed, and debridement and excision of necrotic tissue were performed. After confirming that the infection was under control, we planned the reconstruction of the urethra and penis, following endoscopic urethrotomy for the bulbous urethra stricture. A free graft from the buccal mucosa was harvested, placed over the defect and fixed with interrupted suture as ventral onlay. The patient could achieve satisfactory voiding and no complication was seen during the 18-month follow up. In our experience, buccal mucosa is a useful source of urethral grafting material and excellent results can be expected in case of urethral injury.

Humans↗
PubMed1991

Congenital urethral diverticulum in the male: a twenty-one year old man with a congenital urethral diverticulum at the bulbous urethra.

Diverticula of the urethral wall are not common. Generally, in the male, congenital urethral diverticulum is located in the anterior urethra. We report a twenty-one year old man who referred to our department for dysuria, micturition in two times, small stream urination. Sometimes he also presented a dry ejaculation. The exams showed, at the bulbous portion of the urethra, an urethral diverticulum. The diverticulum was probably congenital because the patient had no history of urinary infection, catheterization or trauma. A surgery procedure was performed. 9 months later, the result is good.

Adult↗
PubMed1998

Prenatal sonographic diagnosis of posterior urethral valves: identification of valves and thickening of the posterior urethral wall.

This report describes 2 heretofore unreported sonographic findings that may aid in the antenatal diagnosis of posterior urethral valves. Each of 2 fetuses showed a prominent or thickened posterior urethra and one or more bright echogenic lines representing valve tissue within a dilated and/or thickened posterior urethra. These findings helped solidify the antenatally suspected diagnosis of posterior urethral valves. The diagnosis was confirmed clinically and surgically during neonatal life. These 2 imaging findings may help in providing a more definitive antenatal diagnosis of posterior urethral valves and allow more expeditious therapy.

Adolescent↗
PubMed2004

Urethral retro-resistance pressure: a new clinical measure of urethral function.

AIMS: The urethral retro-resistance pressure (URP) is a new retrograde measurement of urethral function. URP is the pressure required to achieve and maintain an open sphincter. The assessment of any potential diagnostic measure must include an evaluation in individuals both with and without disease. In this study, we examined URP values in women without urinary incontinence. METHODS: Four centers enrolled 61 women who did not report symptoms of urinary incontinence, and who had negative standing stress tests (SST). Each center was to perform three consecutive URP measurements on each subject. At two centers, 32 subjects returned in 3-7 days for three additional URP measurements. We compared the average URP in this asymptomatic population to the average URP from women symptomatic of stress urinary incontinence (SUI) derived from a previous study. We evaluated the within-subject variation of the URP measurement at a single visit and the within-subject change in URP over time using test and retest values. RESULTS: The mean age was 33 +/- 9 years and the mean body mass index (BMI) was 24 +/- 6. URP values were normally distributed. The mean URP at visit 1 was 112.6 +/- 39.2 cm H2O (n = 60). This was statistically significantly different from the mean URP of symptomatic women (69.9 cm H2O, P < 0.0001). The within-subject standard deviation of URP at visit 1 was 12.6 +/- 12.6 cm H2O (n = 60) and at retest visit was 9.3 +/- 6.2 cm H2O (n = 32). For the retest cases, the mean URP at visit 1 was 113.9 +/- 39.9 cm H2O (n = 32) and at retest visit was 125.5 +/- 33.9 cm H2O (n = 32) (Wilcoxon Signed Rank test, P = 0.145). CONCLUSIONS: The mean URP measurement obtained in this study of asymptomatic women showed significantly higher values when compared to our study in women with SUI. The URP measurements were consistent within the same subject. Furthermore, there was no statistically significant difference in the URP measurement from visit 1 to retest visit. The data suggest that URP shows promise as a physiological urethral pressure measurement.

Adult↗
PubMed1991

Urethral pressure changes in women with detrusor instability. Bladder or urethral pathologic process?

One hundred and fourteen female patients had clinical and urodynamic diagnosis of detrusor instability. They all received oxybutynin chloride (Ditropan) 5 mg t.i.d. for four weeks and evaluation repeated. Sixty-six of the 114 patients (58%) responded favorably to anticholinergic treatment while 48 patients (42%) did not. Based on urethrocystometry, two groups of patients were identified: Group I consisted of 73 women with bladder contraction that preceded any change in urethral pressure. Group II consisted of 41 patients with urethral pressure drop that preceded the detrusor contraction by a few seconds. Sixty-one of the 73 women (84%) in Group I responded favorably to four weeks of anticholinergic therapy while 88 percent (36 of 41) of women in Group II did not (P less than 0.01). Our results suggest that women with bladder contraction that is preceded by urethral relaxation represent a different pathologic entity than women with "classic detrusor instability".

Adult↗