Anterior urethral stricture review
Marshall J Stein1, Rowena A DeSouza1
11 UT Urology Resident, 6410 Fannin, Suite 420, Houston, Texas 77030, USA ; 2 Division of Urology, Medical Director of UTP Urology Clinic, USA.
Translational Andrology and Urology
|January 28, 2016
Summary
Urologists often undertreat male anterior urethral strictures with dilation or internal urethrotomy, despite high urethroplasty success rates. This review examines causes, diagnosis, and management of urethral strictures.
Area of Science:
- Urology
- Surgical Innovation
Background:
- Male anterior urethral stricture is a common urological condition.
- Many urologists treat strictures with dilation or internal urethrotomy, leading to recurrence.
- Urethroplasty, a highly successful treatment, is underutilized by approximately half of practicing urologists in the US.
Purpose of the Study:
- To review the etiology, diagnosis, and management of anterior urethral strictures.
- To compare different treatment options for urethral strictures.
- To address the underutilization of urethroplasty in modern practice.
Main Methods:
- Review of current literature on urethral stricture disease.
- Analysis of a National Practice Survey of Board Certified Urologists.
- Comparison of treatment outcomes for dilation, internal urethrotomy, and urethroplasty.
Main Results:
- Most urologists treat 6-20 urethral strictures annually.
- Repeated dilation and internal urethrotomy are common despite high recurrence rates.
- Urethroplasty is underutilized, with about 50% of urologists not performing the procedure.
Conclusions:
- The traditional reconstructive ladder for urethral strictures may be outdated.
- There is a need to re-evaluate and promote effective treatments like urethroplasty.
- Further research and education are needed to improve anterior urethral stricture management.
Related Concept Videos
01:25Urinary Tract Calculi VI: Surgical Management
808
Procedures for Kidney StonesMedical intervention is necessary when kidney stones or renal calculi are too large to pass spontaneously (typically greater than 5 millimeters) when stones are accompanied by symptomatic infection (such as fever or pyelonephritis), when they impair kidney function, or when they cause persistent symptoms like severe pain, nausea, or urinary retention. Additionally, patients with only one kidney or those who cannot be treated with medical management also require...
808
01:28Urologic Endoscopic Procedure: Cystoscopic Examination
5.2K
Meaning of Cystoscopic Examination:Cystoscopy is an essential diagnostic tool in urology that is used to assess the structure and function of the genitourinary system. It provides a direct view of the urethra, bladder, and, in some cases, the ureteral openings. This procedure helps detect structural abnormalities, infections, cancers, and blockages in the urinary tract. There are two types of cystoscopy:Flexible cystoscopy is commonly performed in outpatient settings due to its less invasive...
5.2K
01:30Esophageal Strictures-I: Introduction
1.1K
Esophageal strictures involve abnormal narrowing or tightening of the esophagus. They vary in length and severity, ranging from mild constriction to complete obstruction, and are classified as benign (noncancerous) or malignant (cancerous).
Etiology
The primary cause of esophageal strictures is long-standing gastroesophageal reflux disease (GERD), accounting for about 70 to 80% of adult cases. Chronic acid reflux can lead to injury and scarring of the esophageal lining, culminating in...
Etiology
The primary cause of esophageal strictures is long-standing gastroesophageal reflux disease (GERD), accounting for about 70 to 80% of adult cases. Chronic acid reflux can lead to injury and scarring of the esophageal lining, culminating in...
1.1K
01:30Urinary Tract Calculi III: Medical Management
319
The diagnosis of renal calculi involves several imaging techniques, including non-contrast CT scans and ultrasound. These methods help visualize kidney stones, assess their size and location, and detect possible obstructions. Additionally, Measuring urine pH is useful for diagnosing specific stone types, such as struvite (alkaline pH) and uric acid stones (acidic pH). Cystine stones are primarily linked to cystinuria, a genetic condition. A urinalysis helps detect blood in the urine (hematuria)...
319
01:16Urethra
5.8K
The urethra is a hollowed tubular organ through which urine is expelled from the body. This structure extends from the bladder to the external opening, allowing urine to be released.
The anatomy of the urethra differs between males and females. In females, the urethra is short, measuring about 3–4 cm in length, and opens anterior to the vaginal opening. In males, the urethra is longer and passes through the penis, serving dual purposes: expelling urine and ejaculating semen. The male...
The anatomy of the urethra differs between males and females. In females, the urethra is short, measuring about 3–4 cm in length, and opens anterior to the vaginal opening. In males, the urethra is longer and passes through the penis, serving dual purposes: expelling urine and ejaculating semen. The male...
5.8K
01:26Esophageal Strictures-II: Clinical Features and Management
886
Patients with esophageal strictures often experience a range of symptoms. Initially, they may have difficulty swallowing solid foods, which can progress to include liquids. Additional symptoms may involve chest pain or discomfort, regurgitating food and fluids, heartburn, unintentional weight loss, coughing or choking during meals, and hoarseness.
Healthcare providers should gather a comprehensive medical history and conduct a physical examination for diagnosis. If esophageal stricture is...
Healthcare providers should gather a comprehensive medical history and conduct a physical examination for diagnosis. If esophageal stricture is...
886