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OBJECTIVE@#To document the VMMC Urethral Dilatation Protocol, established in Veterans MemorialMedical Center for male patients with urethral stricture who underwent urethrotomy and to determineif there is a significant difference in the International Prostate Symptom Score and Uroflowmetrystudies after urethral dilatation in male patients with urethral stricture who underwent urethrotomy.@*MATERIALS AND METHODS@#The is a descriptive, retrospective chart review of male patients in VeteransMemorial Medical Center diagnosed with urethral strictures via voiding cystourethrogram or flexiblecystoscopy who underwent urethrotomy. A total of 24 patients were enrolled in this study, all ofwhom were post TURP patients. All patients with recurrent urethral stricture, history of trauma andpatients with infectious causes of stricture were excluded. Each patient's International ProstateSymptom Score and Uroflowmetry studies prior to urethrotomy and post urethrotomy who underwentthe VMMC urethral dilatation were collected. Median and range (Minimum-Maximum) were usedto describe the variables of the study. These variables are IPSS, peak flow rate, average flow rate,voided volume, and residual volume.@*RESULTS@#The IPSS, was statistically lower after urethrotomy with urethral dilatation and theuroflowmetry parameters (peak flow rate, average flow rate, voided volume, and residual volume)were statistically improved after urethrotomy with urethral dilatation.@*CONCLUSION@#The Urethral Dilatation Protocol established in Veterans Memorial Medical Center andwhich is done every week for 1 month, then every 2 weeks for another 1 month, and monthly untilthere is markedly improved International Prostate Symptom Score showed that this timing may helpimprove IPSS and patient symptoms but not lessen recurrence rates.
ABSTRACT
Objective: To determine the therapeutic effect of regular urethral dilatation on patients with postoperative urethral stricture. Methods: A total of 142 patients underwent urethral stricture. The unimproved patients after the surgery were divided into a reoperation group and a regular urethral dilatation group. All the patients were followed up for 1-3 months, and the curative effect was compared. Results: Of the 142 patients, 42 had no improvement and 27 of them had reoperation, and symptoms in 21 were improved. Another 15 patients received regular urethral dilatation, and 5 improved. hTere was signiifcant difference between the 2 groups (P<0.01). Conclusion: Regular urethral dilatation has some effect on postoperative patients, but no obvious effect on patients with dissatisifed operation for urethral stricture or restenosis.
ABSTRACT
Objective To study the therapeutic effects of pedicled greater omentum displacement for complex posterior urethral stricture. Methods This study included 6 cases (all males) of complex posterior urethral stricture.Their age ranged from 14 to 45 years with a mean of 26 years.In these cases,traffic accident injury occurred in 5 and falling injury in 1.The course of diseases ranged from 6 months to 5 years with a mean of 2.5 years.The length of stricture segment was from 3.0 to 5.5 cm.All cases were surgically treated via transpubic approach and pedicled greater omentum displacement. Results Good operative results were achieved in all 6 cases.Each of them could urinate when the catheter was taken out 4 weeks later,and no urinary incontinence,urinary tract infection were observed.All were followed up for a median period of 26 months (ranged from 6 to 38 months).4 patients had normal micturition with no need of urethral dilatation and 2 patients reencountered dysuria in 3 months and were all cured by the administration of urethral dilatation for 3 to 24 months. Conclusions This procedure has a higher success rate.It is suitable for those with complicated posterior urethral stricture,such as longer posterior urethral stricture,urethra-rectal fistula, false passage, and especially those having experienced failure of urethra repair via perineal approach. It can be regarded as one of the ideal and effective therapeutic methods for complex posterior urethral stricture.
ABSTRACT
clinical observation was possible only in 92 of the 159 patients with urethral stricture, who visited the out-patient clinic of Urology in Pusan National University Hospital from the year of 1956 through 1966 In 82 of the 92 cases observed, gradual and periodic urethral dilatations were performed and satisfactory successes were obtained in 25 of them. The results were as follows 1. Urethral dilatations were indicated for the cases in which #18 or less French metal sound gave resistance or difficulties passing the urethra in male and #20 or less French metal sound in female. 2. The urethral dilatation, were performed by inserting #20~22 French metal sound in the urethra first to confirm the area of stricture. If those sounds were not passed, sounds of less size than them or filiform bougies were inserted. When passage of sound of a certain size was successful, sounds of bigger and bigger size approaching #20~24 French were inserted and in severe cases. Foley catheters were indwelled after urethral dilations. 3. Usually, 11-15 times of gradual and periodic urethral dilatations with interval of 3~5 days, totaling about two months should be done. The indwelled catheters were changed every one to two weeks. totaling 6~8 weeks of indwelling and then gradual and periodic urethral dilations were performed after removal of the indwelled catheter. 4. The results of urethral dilatations were successful in 80 per cent, improved 12 per cent and ineffective 8 per cent respectively. 5. Anatomical knowledge on the urethra, and skillful technique and meticulous cares were essential for successful urethral dilatations.