Objective:To prospectively follow up a cohort of anterior urethral stricture disease patients managed with balloon dilation(BD)for 3 years to evaluate the long-term outcomes and to study factors that contribute to rec...Objective:To prospectively follow up a cohort of anterior urethral stricture disease patients managed with balloon dilation(BD)for 3 years to evaluate the long-term outcomes and to study factors that contribute to recurrence.Methods:This study included men who had urethral BD for significant anterior urethral stricture disease between January 2017 and March 2019.Data about the patient age,stricture characteristics,and recurrence date were recorded,along with information on postoperative indwelling catheter use and operative complications.Furthermore,information about the self-calibration procedure was collected and where available,free flow(FF)measurements during the follow-up period were recorded and analyzed.Success was defined as a lack of symptoms and acceptable FF rates(maximum flow rate>12 mL/s).Results:The final analysis was conducted on 187 patients.The mean follow-up period was 37 months.The long-term overall success rate at the end of our study was 66.8%.Our recurrence rate was 7.4%at 12 months,24.7%at 24 months,and reached 33.2%at the end of our study.The time to recurrence ranged from 91 days to 1635 days,with a mean of 670 days.The stricture-free survival was significantly shorter with lengthy peno-bulbar(p=0.031)and multiple strictures(p=0.015),and in the group of patients who were not committed to self-calibration protocol(p<0.011).However,post-procedural self-calibration was the most important factor that may have decreased the incidence of recurrence(odds ratioZ5.85).Adjuvant self-calibration after BD not only reduced the recurrence rate from 85.4%in the non-self-calibration group to 15.1%in the self-calibration one(p<0.001),but also improved the overall stricture-free survival and FF parameters.展开更多
BACKGROUND While several treatment options are available for pediatric urethral strictures,the appropriate treatment must be based on several factors.Although endoscopic visual internal urethrotomy(EVIU)could be a fir...BACKGROUND While several treatment options are available for pediatric urethral strictures,the appropriate treatment must be based on several factors.Although endoscopic visual internal urethrotomy(EVIU)could be a first-line treatment option for short pediatric urethral strictures,it is not feasible if the urethroscope cannot pass through the stricture point.Herein,we present a pediatric case of severe posttraumatic bulbous urethral stricture that was successfully treated by EVIU after securing the urethral route via interventional balloon dilatation.CASE SUMMARY A 12-year-old boy presented at our outpatient clinic with the inability to urinate.He had sustained a straddle injury three months prior.The post-void residual urine volume was 644 mL,and retrograde urethrography confirmed severe stricture of the bulbous urethra.EVIU was planned;however,the first attempt to treat the stricture failed because the urethroscope could not pass through the stricture point.The urethral route was subsequently secured via balloon dilatation of the stricture,which was performed in collaboration with specialists from the department of interventional radiology.The urethroscope was then able to pass,and the repeat EVIU was successful.CONCLUSION Interventional urethral balloon dilatation before EVIU may help secure the urethral route in the treatment of pediatric urethral strictures.展开更多
目的探讨球囊导管结合等离子治疗男性后尿道狭窄的临床经验。方法选择2017年8月至2019年11月承德医学院附属医院收治男性尿道狭窄患者42例。采用随机数字表法分为内镜组和开放组各21例,内镜组进行球囊导管结合等离子电切术治疗,开放组...目的探讨球囊导管结合等离子治疗男性后尿道狭窄的临床经验。方法选择2017年8月至2019年11月承德医学院附属医院收治男性尿道狭窄患者42例。采用随机数字表法分为内镜组和开放组各21例,内镜组进行球囊导管结合等离子电切术治疗,开放组进行尿道狭窄段切除端端吻合成形术治疗,统计两组患者手术时间、术中失血量、术后住院天数、住院费用;检测术前和术后拔除尿管1个月最大尿流率(Qmax)、残余尿量(residual urine volume,RUV)、国际前列腺症状(international prostate symptom score,IPSS)评分、生活质量(quality of life assessment,QOL)评分;记录拔管后6个月国际勃起功能(international index of erectile function,IIEF-5)评分;对比两组术后1年并发症发生率。结果内镜组的手术时间、术中失血量、术后住院天数低于开放组,差异有显著性(P<0.05);内镜组的住院费用高于开放组,差异有显著性(P<0.05);术后1年,内镜组手术并发症发生率与开放组差异无显著性(P>0.05)。两组术后RUV均低于术前,术后Qmax均高于术前(P<0.05);两组手术前后内镜组RUV、Qmax与开放组差异无显著性(P>0.05);两组术后IPSS评分、QOL评分、IIEF-5评分均较术前降低,差异有显著性(P<0.05);两组术前的IPSS评分、QOL评分、IIEF-5评分差异无显著性(P>0.05);两组术后的IPSS评分、QOL评分差异无显著性(P>0.05),内镜组术后的IIEF-5评分高于开放组,差异有显著性(P<0.05)。结论球囊扩张后继续等离子切除术治疗后尿道狭窄能改善患者排尿功能,提高生活质量。展开更多
文摘Objective:To prospectively follow up a cohort of anterior urethral stricture disease patients managed with balloon dilation(BD)for 3 years to evaluate the long-term outcomes and to study factors that contribute to recurrence.Methods:This study included men who had urethral BD for significant anterior urethral stricture disease between January 2017 and March 2019.Data about the patient age,stricture characteristics,and recurrence date were recorded,along with information on postoperative indwelling catheter use and operative complications.Furthermore,information about the self-calibration procedure was collected and where available,free flow(FF)measurements during the follow-up period were recorded and analyzed.Success was defined as a lack of symptoms and acceptable FF rates(maximum flow rate>12 mL/s).Results:The final analysis was conducted on 187 patients.The mean follow-up period was 37 months.The long-term overall success rate at the end of our study was 66.8%.Our recurrence rate was 7.4%at 12 months,24.7%at 24 months,and reached 33.2%at the end of our study.The time to recurrence ranged from 91 days to 1635 days,with a mean of 670 days.The stricture-free survival was significantly shorter with lengthy peno-bulbar(p=0.031)and multiple strictures(p=0.015),and in the group of patients who were not committed to self-calibration protocol(p<0.011).However,post-procedural self-calibration was the most important factor that may have decreased the incidence of recurrence(odds ratioZ5.85).Adjuvant self-calibration after BD not only reduced the recurrence rate from 85.4%in the non-self-calibration group to 15.1%in the self-calibration one(p<0.001),but also improved the overall stricture-free survival and FF parameters.
基金Supported by the National Research Foundation of Korea Grant founded by the Korea Government,No.NRF-2022R1A2C1007169.
文摘BACKGROUND While several treatment options are available for pediatric urethral strictures,the appropriate treatment must be based on several factors.Although endoscopic visual internal urethrotomy(EVIU)could be a first-line treatment option for short pediatric urethral strictures,it is not feasible if the urethroscope cannot pass through the stricture point.Herein,we present a pediatric case of severe posttraumatic bulbous urethral stricture that was successfully treated by EVIU after securing the urethral route via interventional balloon dilatation.CASE SUMMARY A 12-year-old boy presented at our outpatient clinic with the inability to urinate.He had sustained a straddle injury three months prior.The post-void residual urine volume was 644 mL,and retrograde urethrography confirmed severe stricture of the bulbous urethra.EVIU was planned;however,the first attempt to treat the stricture failed because the urethroscope could not pass through the stricture point.The urethral route was subsequently secured via balloon dilatation of the stricture,which was performed in collaboration with specialists from the department of interventional radiology.The urethroscope was then able to pass,and the repeat EVIU was successful.CONCLUSION Interventional urethral balloon dilatation before EVIU may help secure the urethral route in the treatment of pediatric urethral strictures.
文摘目的探讨球囊导管结合等离子治疗男性后尿道狭窄的临床经验。方法选择2017年8月至2019年11月承德医学院附属医院收治男性尿道狭窄患者42例。采用随机数字表法分为内镜组和开放组各21例,内镜组进行球囊导管结合等离子电切术治疗,开放组进行尿道狭窄段切除端端吻合成形术治疗,统计两组患者手术时间、术中失血量、术后住院天数、住院费用;检测术前和术后拔除尿管1个月最大尿流率(Qmax)、残余尿量(residual urine volume,RUV)、国际前列腺症状(international prostate symptom score,IPSS)评分、生活质量(quality of life assessment,QOL)评分;记录拔管后6个月国际勃起功能(international index of erectile function,IIEF-5)评分;对比两组术后1年并发症发生率。结果内镜组的手术时间、术中失血量、术后住院天数低于开放组,差异有显著性(P<0.05);内镜组的住院费用高于开放组,差异有显著性(P<0.05);术后1年,内镜组手术并发症发生率与开放组差异无显著性(P>0.05)。两组术后RUV均低于术前,术后Qmax均高于术前(P<0.05);两组手术前后内镜组RUV、Qmax与开放组差异无显著性(P>0.05);两组术后IPSS评分、QOL评分、IIEF-5评分均较术前降低,差异有显著性(P<0.05);两组术前的IPSS评分、QOL评分、IIEF-5评分差异无显著性(P>0.05);两组术后的IPSS评分、QOL评分差异无显著性(P>0.05),内镜组术后的IIEF-5评分高于开放组,差异有显著性(P<0.05)。结论球囊扩张后继续等离子切除术治疗后尿道狭窄能改善患者排尿功能,提高生活质量。
