Background: Urethral stricture is a pathology frequently encountered in urological practice. Management is often surgical, with possible recurrences. What about this pathology in Kara, a semi-urban city? Objective: As...Background: Urethral stricture is a pathology frequently encountered in urological practice. Management is often surgical, with possible recurrences. What about this pathology in Kara, a semi-urban city? Objective: Assess the management of male urethral stricture in Kara. Patients and Methods: This was a descriptive study with retrospective data collection. The study took place in the urology department of the teaching hospital of Kara, from December 2020 to December 2022. All cases of male urethral stricture, surgically treated at the teaching hospital of Kara, were listed. The inclusion criteria were as follows: any patient who had been treated surgically for male urethral stricture in the urology department of the teaching Hospital of Kara. The operating theater register and hospital records were used to collect the data. The diagnosis of urethral stricture had been made with retrograde urethrogram. A total of 24 patients were treated for male urethral stricture during the study period. The following variables were studied: age, reason for consultation, location, length, and etiology of the stricture;the type of treatment received: optical internal urethrotomy, or anastomotic urethroplasty, and the results. The result was considered good if, after removal of the urethral catheter, the patient regained his micturition without the need for dilatation;the result was considered average if, after removal of the urethral catheter, the patient needed one or more dilatation sessions to regain urination;the result was considered poor if, after removal of the catheter, the patient did not regain good micturition despite the urethral dilatation sessions. Microsoft excel and epi info 7 software were used for data processing. Results: The average age of our patients was 43.7 years ± 10.18 with extremes ranging from 27 to 70 years. The most represented age groups were that of 40 to 50 years, with 37.5% of cases;and that of 30 to 40 years with 33.3% of cases. The patients had consulted for urine retention in 66.6% of cases;the location of urethral stricture was bulbar in 45.8% of cases. The most found etiology was infectious in 58.3% of cases. Among our patients, 58.3% had received optical internal urethrotomy as treatment, while 41.6% of our patients had received anastomotic urethroplasty as treatment. Postoperatively, after removal of the urinary catheter, 87.5% of patients had benefited from one or repeated dilatation. In terms of results, we had a good result in 20.8% of patients;the result was average in 45.8% of patients, and poor in 33.3% of patients. The average duration of follow-up was 14.3 +/- 7.2 months (3-27). Conclusion: Male urethral stricture mainly affects young adults in Kara. Surgical management is done by optical internal urethrotomy and/or anastomotic urethroplasty.展开更多
Objectives: To report the experiment conducted at the HOGGY Urology department in the management of urethral stricture by urethroplasty, and to determine the factors that influence the results. Material and Method: We...Objectives: To report the experiment conducted at the HOGGY Urology department in the management of urethral stricture by urethroplasty, and to determine the factors that influence the results. Material and Method: We conducted a descriptive and analytical retrospective study based on the records of patients who underwent urethroplasty in the department, between February 2001 and September 2013. Results: Ninety-one (91) patients were enrolled. Urethroplasties prevalence was 0.83% of the surgical activity of the service. The mean age of patients was 39.83 years. Dysuria (30.77%) followed by pelvic trauma (28.57%) and urinary retentions (25.27%) was the main discovery mode. A periurethral coating was found in 32 patients. The infectious etiology accounted for 44% of cases. In 63% of cases, diagnostic was made by retrograde cystography. The penile urethra was the favorite seat of the UR in 70% of cases. The average length of the urethral stricture (US) was less than 1 cm in 41.17% of cases. The US was unique in more than half of the cases (58.33%). Anastomotic urethroplasty was the best surgical technique with 73.63% of patients. Postoperative morbidity involved 47 patients and was dominated by urinary infections (36 year old). The average duration of follow-up of operated patients was 29 months. After 6 months of follow-up, the best results were obtained with the termino-terminal urethroplasty technique with 62.5%. After a follow-up of 4 years, the success rate was 58.24%. The length of the stenosis and the allocation of gestures on the urethra were the two factors of failure. Conclusion: Stenosis is common in our regions. Treatment results are disappointing. Urethroplasty is the gold standard of surgical treatment and anastomotic urethroplasty gives better results.展开更多
Posterior urethral stenosis(PUS)is a known complication following prostate cancer treatment as well as other benign endoscopic treatments.Patients with PUS often fail initial endoscopic treatments and have persistent ...Posterior urethral stenosis(PUS)is a known complication following prostate cancer treatment as well as other benign endoscopic treatments.Patients with PUS often fail initial endoscopic treatments and have persistent symp-toms negatively affecting quality of life.In the past decade,a variety of dif-ferent surgical techniques and approaches have changed the landscape of PUS management.The goal of this review is to provide details on the his-torical,current,and future direction of the surgical management for PUS.展开更多
目的分析尿道狭窄患者行尿道端端吻合术(excision and primary anastomotic urethroplasty,EPA)后狭窄复发的危险因素。方法回顾性分析2017年1月至2018年12月上海交通大学附属第六人民医院收治的209例尿道狭窄患者的临床资料。年龄42.1(...目的分析尿道狭窄患者行尿道端端吻合术(excision and primary anastomotic urethroplasty,EPA)后狭窄复发的危险因素。方法回顾性分析2017年1月至2018年12月上海交通大学附属第六人民医院收治的209例尿道狭窄患者的临床资料。年龄42.1(5~78)岁。肥胖(体质指数>28 kg/m2)25例(12.0%)。既往有糖尿病史12例(5.7%),术前3个月吸烟史103例(49.3%)。术前未行尿道扩张127例(60.8%),尿道扩张1~2次42例(20.1%),尿道扩张≥3次40例(19.1%)。术前有尿道内切开术史56例(26.8%)。术前无尿道成形术史157例(75.1%),尿道成形术1次38例(18.2%),尿道成形术≥2次14例(6.7%)。术前行膀胱造瘘201例(96.2%),未行膀胱造瘘8例(3.8%)。后尿道狭窄183例,球部尿道狭窄26例。狭窄时间35.1(1~360)个月。狭窄段长度(3.19±0.65)cm。病因为外伤190例,医源性损伤12例,炎性狭窄2例,其他5例。患者均行EPA治疗,69例(33.0%)术中行耻骨下缘切除。术后复发标准:拔除导尿管后出现排尿困难,经尿道镜或尿道造影检查提示手术部位尿道狭窄。对可能导致狭窄复发的因素采用Cox比例风险回归模型进行单因素和多因素分析。结果本组209例术后随访18.8(3~32)个月。31例(14.8%)出现狭窄复发,复发时间(5.3±5.6)个月。单因素分析结果显示,狭窄时间(HR=1.007,P<0.001),狭窄段长度(HR=5.334,P<0.001),尿道内切开术史(HR=2.901,P=0.003),尿道扩张≥3次(HR=6.214,P<0.001),尿道成形术1次、≥2次(HR=4.175,P=0.001、HR=9.885,P<0.001),术前3个月吸烟史(HR=2.605,P=0.016),膀胱造瘘(HR=0.231,P=0.006),耻骨下缘切除(HR=6.603,P<0.001)与狭窄复发有相关性。多因素分析结果显示狭窄段长度(HR=4.911,P<0.001),尿道成形术1次、≥2次(HR=2.387,P=0.045、HR=3.688,P=0.015),术前3个月吸烟史(HR=2.730,P=0.030)是狭窄复发的独立危险因素。结论EPA术后尿道狭窄复发多集中在术后6个月内,患者尿道狭段窄长度、尿道成形术史、术前3个月吸烟史是狭窄复发的独立危险因素。展开更多
目的:研究尿道端端吻合术对外伤性尿道狭窄患者勃起功能的影响。方法:对41例采用尿道端端吻合术治疗的骨盆骨折导致尿道损伤(PFUDD)相关尿道狭窄患者手术前后两个阶段进行血管活性药物注射后阴茎血流彩色多普勒超声波(PPUD)检查和国际...目的:研究尿道端端吻合术对外伤性尿道狭窄患者勃起功能的影响。方法:对41例采用尿道端端吻合术治疗的骨盆骨折导致尿道损伤(PFUDD)相关尿道狭窄患者手术前后两个阶段进行血管活性药物注射后阴茎血流彩色多普勒超声波(PPUD)检查和国际勃起功能指数-5(11EF-5)间卷调查,并对数据进行统计学分析。结果:所有41例患者手术前后的IIEF-5评分无显著差异,且勃起功能无明显变化者占大多数,约为56%。各年龄组、狭窄长度组及狭窄部位组患者手术前后的IIEF-5评分均无显著差异,但术后勃起功能提高组、不变组和降低组3组间的狭窄长度差异有统计学意义(2.16±1.49 vs 2.28±0.88 vs 3.50±1.53,P=0.0134),且差异主要存在于降低组与提高组或不变组之间(P=0.0129,0.0165)。轻度及中低度ED组患者术后IIEF-5评分出现明显下降(13.86±1.88 vs 11.43±3.37,P=0.0202),而中度及重度ED组患者则无明显变化。非血管性ED组患者手术前后的IIEF-5评分差异有统计学意义(14.88±1.81 vs 10.88±4.02,P=0.0103),动脉性和静脉性ED组患者手术前后评分则无明显差别。结论:尿道端端吻合术对PFIDD等外伤相关尿道狭窄患者的勃起功能没有显著影响,患者术后勃起功能的变化情况与狭窄长度、术前性功能状态等有关,而与患者年龄、狭窄部位等没有明确的关系。展开更多
文摘Background: Urethral stricture is a pathology frequently encountered in urological practice. Management is often surgical, with possible recurrences. What about this pathology in Kara, a semi-urban city? Objective: Assess the management of male urethral stricture in Kara. Patients and Methods: This was a descriptive study with retrospective data collection. The study took place in the urology department of the teaching hospital of Kara, from December 2020 to December 2022. All cases of male urethral stricture, surgically treated at the teaching hospital of Kara, were listed. The inclusion criteria were as follows: any patient who had been treated surgically for male urethral stricture in the urology department of the teaching Hospital of Kara. The operating theater register and hospital records were used to collect the data. The diagnosis of urethral stricture had been made with retrograde urethrogram. A total of 24 patients were treated for male urethral stricture during the study period. The following variables were studied: age, reason for consultation, location, length, and etiology of the stricture;the type of treatment received: optical internal urethrotomy, or anastomotic urethroplasty, and the results. The result was considered good if, after removal of the urethral catheter, the patient regained his micturition without the need for dilatation;the result was considered average if, after removal of the urethral catheter, the patient needed one or more dilatation sessions to regain urination;the result was considered poor if, after removal of the catheter, the patient did not regain good micturition despite the urethral dilatation sessions. Microsoft excel and epi info 7 software were used for data processing. Results: The average age of our patients was 43.7 years ± 10.18 with extremes ranging from 27 to 70 years. The most represented age groups were that of 40 to 50 years, with 37.5% of cases;and that of 30 to 40 years with 33.3% of cases. The patients had consulted for urine retention in 66.6% of cases;the location of urethral stricture was bulbar in 45.8% of cases. The most found etiology was infectious in 58.3% of cases. Among our patients, 58.3% had received optical internal urethrotomy as treatment, while 41.6% of our patients had received anastomotic urethroplasty as treatment. Postoperatively, after removal of the urinary catheter, 87.5% of patients had benefited from one or repeated dilatation. In terms of results, we had a good result in 20.8% of patients;the result was average in 45.8% of patients, and poor in 33.3% of patients. The average duration of follow-up was 14.3 +/- 7.2 months (3-27). Conclusion: Male urethral stricture mainly affects young adults in Kara. Surgical management is done by optical internal urethrotomy and/or anastomotic urethroplasty.
文摘Objectives: To report the experiment conducted at the HOGGY Urology department in the management of urethral stricture by urethroplasty, and to determine the factors that influence the results. Material and Method: We conducted a descriptive and analytical retrospective study based on the records of patients who underwent urethroplasty in the department, between February 2001 and September 2013. Results: Ninety-one (91) patients were enrolled. Urethroplasties prevalence was 0.83% of the surgical activity of the service. The mean age of patients was 39.83 years. Dysuria (30.77%) followed by pelvic trauma (28.57%) and urinary retentions (25.27%) was the main discovery mode. A periurethral coating was found in 32 patients. The infectious etiology accounted for 44% of cases. In 63% of cases, diagnostic was made by retrograde cystography. The penile urethra was the favorite seat of the UR in 70% of cases. The average length of the urethral stricture (US) was less than 1 cm in 41.17% of cases. The US was unique in more than half of the cases (58.33%). Anastomotic urethroplasty was the best surgical technique with 73.63% of patients. Postoperative morbidity involved 47 patients and was dominated by urinary infections (36 year old). The average duration of follow-up of operated patients was 29 months. After 6 months of follow-up, the best results were obtained with the termino-terminal urethroplasty technique with 62.5%. After a follow-up of 4 years, the success rate was 58.24%. The length of the stenosis and the allocation of gestures on the urethra were the two factors of failure. Conclusion: Stenosis is common in our regions. Treatment results are disappointing. Urethroplasty is the gold standard of surgical treatment and anastomotic urethroplasty gives better results.
文摘Posterior urethral stenosis(PUS)is a known complication following prostate cancer treatment as well as other benign endoscopic treatments.Patients with PUS often fail initial endoscopic treatments and have persistent symp-toms negatively affecting quality of life.In the past decade,a variety of dif-ferent surgical techniques and approaches have changed the landscape of PUS management.The goal of this review is to provide details on the his-torical,current,and future direction of the surgical management for PUS.
文摘目的:研究尿道端端吻合术对外伤性尿道狭窄患者勃起功能的影响。方法:对41例采用尿道端端吻合术治疗的骨盆骨折导致尿道损伤(PFUDD)相关尿道狭窄患者手术前后两个阶段进行血管活性药物注射后阴茎血流彩色多普勒超声波(PPUD)检查和国际勃起功能指数-5(11EF-5)间卷调查,并对数据进行统计学分析。结果:所有41例患者手术前后的IIEF-5评分无显著差异,且勃起功能无明显变化者占大多数,约为56%。各年龄组、狭窄长度组及狭窄部位组患者手术前后的IIEF-5评分均无显著差异,但术后勃起功能提高组、不变组和降低组3组间的狭窄长度差异有统计学意义(2.16±1.49 vs 2.28±0.88 vs 3.50±1.53,P=0.0134),且差异主要存在于降低组与提高组或不变组之间(P=0.0129,0.0165)。轻度及中低度ED组患者术后IIEF-5评分出现明显下降(13.86±1.88 vs 11.43±3.37,P=0.0202),而中度及重度ED组患者则无明显变化。非血管性ED组患者手术前后的IIEF-5评分差异有统计学意义(14.88±1.81 vs 10.88±4.02,P=0.0103),动脉性和静脉性ED组患者手术前后评分则无明显差别。结论:尿道端端吻合术对PFIDD等外伤相关尿道狭窄患者的勃起功能没有显著影响,患者术后勃起功能的变化情况与狭窄长度、术前性功能状态等有关,而与患者年龄、狭窄部位等没有明确的关系。
