Urethral stricture disease negatively impacts quality of life and leads to significant urologic pathology including lower urinary tract symptoms, recurrent urinary tract infections, and potentially more severe sequelae such as detrusor dysfunction, renal failure, urethral carcinoma, and Fournier's gangrene. Open urethral reconstruction is considered a durable and definitive treatment for urethral stricture with lifetime success rates ranging from 75-100%; however, strictures do recur up to 10 years after surgery. Recurrence rates vary by repair type. There also is no agreed-upon modality for recurrence surveillance, but there are many modalities with varying degrees of invasiveness. Recurrent strictures may be managed endoscopically or via open repair. We review stricture recurrence rates, surveillance modalities, risk factors, and management options.
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http://dx.doi.org/10.1007/s11934-016-0588-0 | DOI Listing |
World J Urol
January 2025
Department of Urology, Shanghai Sixth People's Hospital, Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Eastern Institute of Urologic Reconstruction, Shanghai, 200233, China.
Purpose: To determine the clinical effects of urethral suspension-assisted urethral anastomosis on complex long-segment posterior urethral stricture and describe the technical aspects of this procedure.
Materials And Methods: The clinical data for 24 patients who underwent urethral suspension-assisted urethral anastomosis for complex long-segment posterior urethral stricture between March 2021 and March 2024 were retrospectively analyzed. The surgical procedure comprises the following four steps: creation of an inverted Y-shaped incision in the perineum; mobilization of the urethra up to the penile-scrotal junction followed by dissection and separation of the septum of the corpus cavernosum; separation of the inferior pubic symphysis, excising a portion of the inferior pubic symphysis bone tissue and thoroughly clearing the scar tissue surrounding the proximal urethra; and suturing and suspension of the proximal urethra and surrounding tissues at the 2, 5, 7, and 10 o'clock positions, ensuring complete exposure of the proximal urethral mucosa and tension-free anastomosis between the proximal and distal urethra.
Int J Urol
January 2025
Department of Urology, National Defense Medical College, Saitama, Japan.
Objectives: To evaluate the feasibility and surgical outcomes of simultaneous urethral reconstruction for synchronous urethral strictures (SUS) and analyze the surgical techniques employed for different stricture combinations.
Methods: Twenty-two male patients with SUS who underwent urethral reconstruction between February 2018 and July 2023 were retrospectively reviewed. Stricture locations and lengths were evaluated using cystoscopy and urethrography after urethral rest for at least 3 months.
Rev Med Suisse
January 2025
Service d'urologie, Centre hospitalier universitaire vaudois, 1011 Lausanne.
In 2024, urology continues to evolve with remarkable innovations. The Da Vinci SP surgical robot simplifies procedures by reducing surgical trauma and accelerating patient recovery. Regarding oncological conditions, new therapies have significantly improved the management of urological cancers, leading to increased survival rates.
View Article and Find Full Text PDFEur J Pediatr Surg
January 2025
Surgery, Colorectal and Pelvic Reconstructive Surgery, Children's National Hospital, District of Columbia, United States.
A novel modification of the cutback procedure, a posterior rectal advancement anoplasty (PRAA) for select male patients with an anorectal malformation and a rectoperineal fistula was recently described which incised only within the limits of the sphincteric ellipse and eliminated an anterior rectal dissection, thus avoiding any possibility of a urethral injury. This report provides longer term postoperative outcomes after PRAA. Method A retrospective, single institution study was performed examining male patients with a rectoperineal fistula between 1/2020-12/2023.
View Article and Find Full Text PDFInt J Urol
January 2025
Department of Urology, National Defense Medical College, Saitama, Japan.
Objectives: To evaluate the efficacy of staged urethroplasty for complex anterior urethral strictures from both surgical and patient-reported outcome perspectives.
Methods: This retrospective study included 100 patients who underwent staged urethroplasty for anterior urethral strictures between May 2011 and June 2023. Anatomical success was defined as the ability to pass cystourethroscopy without resistance and the patient's ability to void without additional interventions.
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