Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Rosenbaum, CM; Schmid, M; Ludwig, TA; Kluth, LA; Reiss, P; Dahlem, R; Engel, O; Chun, FK; Riechardt, S; Fisch, M; Ahyai, SA.
Internal urethrotomy in patients with recurrent urethral stricture after buccal mucosa graft urethroplasty.
World J Urol. 2015; 33(9):1337-44
Doi: 10.1007/s00345-014-1450-y
Web of Science
PubMed
FullText
FullText_MUG
- Führende Autor*innen der Med Uni Graz
- Ahyai Sascha
- Co-Autor*innen der Med Uni Graz
- Leitsmann Marianne
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- Abstract:
- PURPOSE: To determine the success rate of direct vision internal urethrotomy (DVIU) in the treatment of short stricture recurrence after buccal mucosa graft urethroplasty (BMGU). METHODS: Patients who underwent DVIU for the treatment of short, "veil-like" recurrent urethral strictures (<1 cm) after BMGU between October 2009 and 2013 were retrospectively identified within our urethroplasty database. Stricture recurrence was defined as maximum flow rate (Q max) <15 ml/s and a consecutively verified stricture in a combined retro- and antegrade voiding cystography or cystoscopy at a follow-up visit. The success rate of DVIU was assessed by Kaplan-Meier analysis. Univariable Cox regression analyses evaluated risk factors for stricture recurrence following DVIU. RESULTS: Forty-three patients underwent DVIU for short stricture recurrence after BMGU for bulbar (81.3 %), penile (14.0 %) and membranous (4.7 %) strictures. Relapse had occurred proximally to the buccal mucosa graft in 28 (65.1 %) and distally in 12 (27.9 %) patients, respectively. At a mean follow-up of 11.7 (±9.7) months, stricture recurrence was observed in 48.8 % of our patients. Stricture recurrence was significantly associated with weak urinary stream (9.3 ml/s vs. no recurrence 19.5 ml/s) and patient dissatisfaction (66.7 % vs. no recurrence 18.1 %; both p < 0.001). The overall success rate was 60.5 % 15 months after DVIU. The main limitations of this study are its retrospective design, the small sample size and the short follow-up. CONCLUSIONS: DVIU after BMGU showed a moderate success rate and therefore might be a viable treatment option in selected patients with very short strictures after BMGU. However, longer follow-up is warranted to prove long-term effectiveness.
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- Cystoscopy - administration & dosage
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- Humans - administration & dosage
- Male - administration & dosage
- Middle Aged - administration & dosage
- Mouth Mucosa - transplantation
- Reconstructive Surgical Procedures - methods
- Recurrence - administration & dosage
- Reoperation - administration & dosage
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- Urethral Stricture - diagnosis, physiopathology, surgery
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- Find related publications in this database (Keywords)
- Urethral stricture
- Recurrence
- Buccal mucosa graft urethroplasty
- Internal urethrotomy
- Follow-up