| Urethral rest: role and rationale in preparation for anterior urethroplasty. | |
| | |
MedLine Citation:
|
PMID: 21513968 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
OBJECTIVES: To report the outcomes of men treated initially with a period of urethral rest to allow tissue recovery before anterior urethroplasty. Many men referred to referral centers for anterior urethral reconstruction often present soon after the endoscopic manipulation of severe strictures. METHODS: We reviewed our database of all anterior urethroplasties performed by a single surgeon from 2007 to 2009. Urethral rest was accomplished by removal of the indwelling catheter, cessation of self-catheterization, and/or suprapubic urinary diversion before urethral reconstruction. RESULTS: During the study period, 210 patients underwent urethral reconstruction at our center. Men who had undergone meatoplasty or posterior urethroplasty were excluded, leaving 128 anterior urethroplasty patients available for analysis. Of these men, 28 (21%) were preoperatively given an initial period of urethral rest (median duration 3 months) because of recent urologic manipulation occurring immediately before referral. Of the 28 patients, 15 (54%) received suprapubic catheters. Urethral rest promoted identification of severely fibrotic stricture segments, enabling focal or complete excision in 75% (excision and primary anastomosis in 12 [43%] and augmented anastomosis in 9 [32%]), a percentage similar to that for those undergoing reconstruction without preliminary manipulation mandating urethral rest (82%). Stricture recurrence developed in 4 (14%) of the 28 rest patients, a rate again similar to that for the remainder of the urethroplasty population (10%). CONCLUSIONS: The results of our study have shown that recently manipulated anterior urethral strictures often declare themselves to be obliterative within several months of urethral rest, thus enabling successful urethroplasty by focal or complete excision. |
| | |
Authors:
|
Ryan P Terlecki; Matthew C Steele; Celeste Valadez; Allen F Morey |
Related Documents
:
|
21214368 - A randomized clinical trial on the effect of low-level laser therapy on chronic diabeti... 21256698 - Prevalence and risk factors of thromboembolism after joint arthroplasty without chemica... 21366368 - Safety of continuous propofol sedation for endoscopic procedures in elderly patients. 21211888 - Altered sensation after orthognathic surgery. 16097558 - Technology enhancements and changes in radiotherapy throughput in new south wales. 22228158 - T-pouch: results of the first 10 years with a nonintussuscepting continent ileostomy. |
Publication Detail:
|
Type: Journal Article Date: 2011-04-21 |
Journal Detail:
|
Title: Urology Volume: 77 ISSN: 1527-9995 ISO Abbreviation: Urology Publication Date: 2011 Jun |
Date Detail:
|
Created Date: 2011-05-31 Completed Date: 2011-08-12 Revised Date: 2012-02-15 |
Medline Journal Info:
|
Nlm Unique ID: 0366151 Medline TA: Urology Country: United States |
Other Details:
|
Languages: eng Pagination: 1477-81 Citation Subset: IM |
Copyright Information:
|
Copyright © 2011 Elsevier Inc. All rights reserved. |
Affiliation:
|
Department of Urology, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Anastomosis, Surgical Catheterization Catheters Endoscopy / methods Humans Male Reconstructive Surgical Procedures / adverse effects Recurrence Treatment Outcome Urethra / pathology*, surgery* Urethral Stricture / surgery* Urologic Surgical Procedures / methods* Urology / methods Wound Healing |
| Comments/Corrections | |
Comment In:
|
J Urol. 2012 Feb;187(2):550-1
[PMID:
22237335
]
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Selective sludge removal in a segregated aerobic granular biomass system as a strategy to control PA...
Next Document: Induction of tolerance to parental parathyroid grafts using allogeneic thymus tissue in patients wit...