Objective:The management of urethral stricture disease depends on the location,length of stricture,and associated urethral pathology.These parameters are obtained from preoperative imaging,with conventional urethrogra...Objective:The management of urethral stricture disease depends on the location,length of stricture,and associated urethral pathology.These parameters are obtained from preoperative imaging,with conventional urethrogram(retrograde urethrogram and micturating cystourethrogram[RGU/MCU])being the diagnostic tool of choice despite its many shortcomings.Sono-urethrogram(SUG)is an alternative that addresses most issues of RGU/MCU.Studies comparing RGU/MCU with SUG are limited.With the objective of comparing these two imaging modalities in the evaluation of urethral stricture disease,a prospective study was conducted.Methods:Fifty-six patients suspected of urethral stricture disease on clinical evaluation and confirmed either on RGU/MCU or urethro-cystoscopy were included in the study.SUG was performed by the experienced consultant radiologist who was blinded to the report of RGU/MCU.Findings of RGU/MCU and SUG were compared to intraoperative findings,which served as the reference standard.Results:The median length of the stricture determined intraoperatively was 16.5 mm,by RGU/MCU was 5.8 mm,and by SUG was 13.5 mm.The diagnostic accuracy for determination of the stricture location was 93%for RGU/MCU and 98%for SUG.SUG identified spongiofibrosis in 90%of patients with higher accuracy for the severe degree of spongiofibrosis.Conclusion:SUG has been shown to be more accurate than RGU/MCU in estimating stricture length(both short and intermediate)and localizing the stricture location.Use of SUG in conjunction with RGU/MCU helps in better guidance of stricture management by improving preoperative assessment.Further studies with larger sample sizes are warranted.展开更多
Treatment of male urethral trauma is always a challenging problem.In China,as the incidence of urethral trauma keeps rising,more and more studies relating to this are being published.To compare the outcome of differen...Treatment of male urethral trauma is always a challenging problem.In China,as the incidence of urethral trauma keeps rising,more and more studies relating to this are being published.To compare the outcome of different emergency treatments in China and other countries,we searched Chinese and English literature about this topic in the past 16 years.A total of 167 studies involving 5314 patients were included,with 144 in Chinese and 23 in English.All studies were retrospective in nature.Based on the analyses,surgical methods include open realignment,endoscopic realignment and primary repair,and we summarized and compared the success rate and complications(mainly erectile dysfunction and incontinence)of each method.We found that realignment of posterior urethra has similar success rate in China and other countries,but the outcome of realignment of anterior urethra is variable.The reason remains unknown.While long abandoned in Western countries,primary repair of anterior urethra is still an option in China and has high success rate.展开更多
Introduction: The management of post-traumatic stenosis of the posterior urethra is divided between early endoscopic realignment and delayed surgery. In the latter case, several techniques are used taking into account...Introduction: The management of post-traumatic stenosis of the posterior urethra is divided between early endoscopic realignment and delayed surgery. In the latter case, several techniques are used taking into account several factors. Our objective was therefore to investigate the possible prognostic factors of failure of this surgical management. Material and Methods: We conducted a retrospective study from January 2006 to December 2017 on patients admitted to the Urology Department of the Mohammed 6 University Hospital of Marrakech for management of post-traumatic posterior urethral stenosis. The parameters studied were age, medical and surgical history, causes, characteristics of the stenosis (location, number, length), associated lesions, surgical technique used, and evolution. The descriptive analysis consisted of calculation of absolute and relative frequencies for the qualitative variables, and of position and dispersion parameters for the quantitative variables (mean, standard deviation). In bivariate analysis, the comparison of categorical variables used Pearson’s Chi-square statistical test and Fisher’s test if necessary. The significance threshold was set at p Results: A total of 30 cases were selected. The age of our patients varied between 18 and 68 years, with an average of 38.33 years (16 - 80 years);the most affected age group was between 20 and 39 years. The mode of revelation of urethral damage was dominated by acute retention of urine present in 76% of patients, followed by dysuria (33%). The stenosis extended over 21.91 mm on average (14 - 40 mm). It was accompanied by bone involvement in 15 patients (53.3%). Erectile dysfunction was present in 23 patients (23%). Terminal urethrogram was the main surgical technique used, followed by internal urethrotomy (60% and 30% respectively). 15 patients had a recurrence, with an average of 1-second operation. Statistical analysis of the different factors studied showed no correlation with the occurrence of recurrence after surgical treatment. Conclusion: The medium and long term results of anastomotic repair of the posterior urethra do not seem to depend on the lesion parameters of the stenosis (site, number, extent, presence of associated bony lesions or erectile disorders).展开更多
文摘Objective:The management of urethral stricture disease depends on the location,length of stricture,and associated urethral pathology.These parameters are obtained from preoperative imaging,with conventional urethrogram(retrograde urethrogram and micturating cystourethrogram[RGU/MCU])being the diagnostic tool of choice despite its many shortcomings.Sono-urethrogram(SUG)is an alternative that addresses most issues of RGU/MCU.Studies comparing RGU/MCU with SUG are limited.With the objective of comparing these two imaging modalities in the evaluation of urethral stricture disease,a prospective study was conducted.Methods:Fifty-six patients suspected of urethral stricture disease on clinical evaluation and confirmed either on RGU/MCU or urethro-cystoscopy were included in the study.SUG was performed by the experienced consultant radiologist who was blinded to the report of RGU/MCU.Findings of RGU/MCU and SUG were compared to intraoperative findings,which served as the reference standard.Results:The median length of the stricture determined intraoperatively was 16.5 mm,by RGU/MCU was 5.8 mm,and by SUG was 13.5 mm.The diagnostic accuracy for determination of the stricture location was 93%for RGU/MCU and 98%for SUG.SUG identified spongiofibrosis in 90%of patients with higher accuracy for the severe degree of spongiofibrosis.Conclusion:SUG has been shown to be more accurate than RGU/MCU in estimating stricture length(both short and intermediate)and localizing the stricture location.Use of SUG in conjunction with RGU/MCU helps in better guidance of stricture management by improving preoperative assessment.Further studies with larger sample sizes are warranted.
文摘Treatment of male urethral trauma is always a challenging problem.In China,as the incidence of urethral trauma keeps rising,more and more studies relating to this are being published.To compare the outcome of different emergency treatments in China and other countries,we searched Chinese and English literature about this topic in the past 16 years.A total of 167 studies involving 5314 patients were included,with 144 in Chinese and 23 in English.All studies were retrospective in nature.Based on the analyses,surgical methods include open realignment,endoscopic realignment and primary repair,and we summarized and compared the success rate and complications(mainly erectile dysfunction and incontinence)of each method.We found that realignment of posterior urethra has similar success rate in China and other countries,but the outcome of realignment of anterior urethra is variable.The reason remains unknown.While long abandoned in Western countries,primary repair of anterior urethra is still an option in China and has high success rate.
文摘Introduction: The management of post-traumatic stenosis of the posterior urethra is divided between early endoscopic realignment and delayed surgery. In the latter case, several techniques are used taking into account several factors. Our objective was therefore to investigate the possible prognostic factors of failure of this surgical management. Material and Methods: We conducted a retrospective study from January 2006 to December 2017 on patients admitted to the Urology Department of the Mohammed 6 University Hospital of Marrakech for management of post-traumatic posterior urethral stenosis. The parameters studied were age, medical and surgical history, causes, characteristics of the stenosis (location, number, length), associated lesions, surgical technique used, and evolution. The descriptive analysis consisted of calculation of absolute and relative frequencies for the qualitative variables, and of position and dispersion parameters for the quantitative variables (mean, standard deviation). In bivariate analysis, the comparison of categorical variables used Pearson’s Chi-square statistical test and Fisher’s test if necessary. The significance threshold was set at p Results: A total of 30 cases were selected. The age of our patients varied between 18 and 68 years, with an average of 38.33 years (16 - 80 years);the most affected age group was between 20 and 39 years. The mode of revelation of urethral damage was dominated by acute retention of urine present in 76% of patients, followed by dysuria (33%). The stenosis extended over 21.91 mm on average (14 - 40 mm). It was accompanied by bone involvement in 15 patients (53.3%). Erectile dysfunction was present in 23 patients (23%). Terminal urethrogram was the main surgical technique used, followed by internal urethrotomy (60% and 30% respectively). 15 patients had a recurrence, with an average of 1-second operation. Statistical analysis of the different factors studied showed no correlation with the occurrence of recurrence after surgical treatment. Conclusion: The medium and long term results of anastomotic repair of the posterior urethra do not seem to depend on the lesion parameters of the stenosis (site, number, extent, presence of associated bony lesions or erectile disorders).
