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Erectile Function Urethroplasty

Wesley Verla, Willem Oosterlinck, Marjan Waterloos, Nicolaas Lumen
Urethroplasty is considered to be the standard treatment for urethral strictures since it provides excellent long-term success rates. For isolated short bulbar or posterior urethral strictures, urethroplasty by excision and primary anastomosis (EPA) is recommended. As EPA only requires the excision of the narrowed segment and the surrounding spongiofibrosis, a full-thickness transection of the corpus spongiosum, as performed in the traditional transecting EPA (tEPA), is usually unnecessary. Jordan et al. introduced the idea of a vessel-sparing approach in 2007, aiming to reduce surgical trauma, especially to the dual arterial blood supply of the urethra, and, thus, potentially reducing the risk of postoperative erectile dysfunction or glans ischemia...
January 7, 2019: Journal of Visualized Experiments: JoVE
M Waterloos, W Verla, A F Spinoit, W Oosterlinck, E Van Laecke, P Hoebeke, N Lumen
INTRODUCTION: Urethral injuries and trauma-related strictures (UITSs) in children are rare. The treatment is challenging but crucial to avoid life-long urinary complications such as recurrent stricture formation, urinary incontinence, and impotence. OBJECTIVE: The aim was to report on the surgical and functional outcome of urethroplasty for UITSs and to provide data on patient-reported outcome measures (PROMs). MATERIAL AND METHODS: Between November 2001 and October 2017, 18 male children (≤18 years; median: 13 years) underwent urethroplasty for UITSs at a single tertiary referral center...
November 29, 2018: Journal of Pediatric Urology
M I Kogan, B G Amirbekov, M N Kryuchkova, V V Mitusov, V V Krasulin, D V Sizyakin
INTRODUCTION: The relationship of surgical treatment of urethral stricture and such mental deviations as anxiety and depression is still poorly understood. Particularly, there is no reliable data on how mental status is associated to surgical treatment of the urethral stricture and its efficacy. AIM: to study the indicators of anxiety and depression in patients with urethral stricture before and after surgery. MATERIALS AND METHODS: The prospective study involving 30 men aged 20-74 years with urethral stricture of various etiologies and localizations was conducted...
December 2018: Urologii︠a︡
S V Kotov, S V Belomitsev, R I Guspanov, M M Iritsyan, D N Surenkov, M K Semenov, A M Ugurchiev
AIM: In case of complex and long urethral stricture a use of augmentation technique is often limited by "critically" narrowing of urethral plate. In such cases, the augmentation anastomotic urethroplasty without division of the corpus spongiosum can be the method of choice, because it allows to perform simultaneous augmentation urethroplasty with maximal sparing of antegrade blood flow in corpus spongiosum. MATERIALS AND METHODS: In urologic clinic of N...
December 2018: Urologii︠a︡
Mark Broadwin, Alex J Vanni
INTRODUCTION: There is no standardized treatment algorithm for isolated fossa navicularis strictures and treatment modality often falls to surgeon preference. We evaluated the outcomes of a standardized algorithm for fossa navicularis strictures based on stricture etiology, lumen size, and glans size to minimize the number of patients requiring a two-stage urethral reconstruction. MATERIALS AND METHODS: We retrospectively reviewed a prospectively maintained urethral reconstruction database by a single surgeon from 2011-2018...
December 2018: Canadian Journal of Urology
Nabeel A Shakir, Joceline S Fuchs, Nora Haney, Boyd R Viers, Billy H Cordon, Maxim McKibben, Jeremy Scott, Noel A Armenakas, Allen F Morey
OBJECTIVES: To present a multi-institutional experience with functional and patient-reported outcomes among men undergoing excision and primary anastomosis (EPA) urethroplasty for pendulous urethral strictures. METHODS: We describe the technique and present our experience with EPA for focal penile strictures. Patients undergoing urethroplasty (2004-2017) at two tertiary referral centers were reviewed, of whom 14 (0.7%) underwent EPA of radiographically confirmed pendulous urethral strictures...
August 17, 2018: Urology
Alejandro Nieto-Esquivel, Rolando Delgado-Balderas, J Iván Robles-Torres, Lauro S Gómez-Guerra
OBJECTIVE: To evaluate the tadalafil effect in the treatment of erectile dysfunction as a consequence of posterior urethral injury. MATERIAL AND METHODS: This is a retrospective study that included patients with posterior urethral injury caused by previous pelvic fracture; our patients received emergency urethral alignment and urethroplasty between 8 to 10weeks after trauma. To assess the degree of erectile dysfunction pre- and post-treatment, we applied the questionnaire of International Index of Erectile Function (IIEF-5)...
January 2018: Revista Internacional de Andrología
Javier C Angulo, Reynaldo G Gómez, Dmitriy Nikolavsky
PURPOSE OF REVIEW: Due to the proximity of the rhabdosphincter and cavernous nerves to the membranous urethra, reconstruction of membranous urethral stricture implies a risk of urinary incontinence and erectile dysfunction. To avoid these complications, endoscopic management of membranous urethral strictures is traditionally favored, and bulboprostatic anastomosis is reserved as the main classical approach for open reconstruction of recalcitrant membranous urethral stricture. The preference for the anastomotic urethroplasty among reconstructive urologists is likely influenced by the familiarity and experience with trauma-related injuries...
April 11, 2018: Current Urology Reports
Jared P Schober, Kristian D Stensland, Benjamin N Breyer, Bradley A Erickson, Jeremy B Myers, Bryan B Voelzke, Sean P Elliott, Jill C Buckley, Alex J Vanni
PURPOSE: To our knowledge anxiety and depression in patients with urethral stricture disease and the impact of urethroplasty on mental health has never been explored. We hypothesized that patients with urethral stricture disease would have higher than normal anxiety and depression levels, and urethroplasty would improve mental health. MATERIALS AND METHODS: We retrospectively reviewed the records of patients in a multi-institutional reconstructive urology database who underwent anterior urethroplasty...
June 2018: Journal of Urology
Jalil Hosseini, Farzen Soleimanzadeh Ardebili, Behrouz Fadavi, Hamidreza Haghighatkhah
PURPOSE: Although improvements in urological function have been less challenged, concern about andrological problems following urethral stricture surgeries has been growing in recent years. The aim of this study is to evaluate the role of the anastomotic urethroplasty itself on erectile function in patients with posterior urethral injuries. MATERIALS AND METHODS: In this prospective cohort study, patients with urethral strictures referring to Tajrish Hospital during October 2013 to August 2016 for anastomotic urethroplasty, were included...
March 18, 2018: Urology Journal
Allen F Morey
No abstract text is available yet for this article.
December 2017: Journal of Urology
Cooper R Benson, Ly Hoang, Jonathan Clavell-Hernández, Run Wang
INTRODUCTION: Urethral stricture disease accounts for 5,000 hospitalizations and 1.5 million office visits per year. Urethral reconstruction has become more commonplace with the recognition of the poor long-term success of the endoscopic management of stricture disease. Sexual dysfunction related to the surgical management of urethral strictures is an under-recognized sequela. AIM: To characterize and elucidate the various factors that contribute to sexual dysfunction after urethroplasty and hypospadias reconstruction to improve surgical decision making and patient counseling...
July 2018: Sexual Medicine Reviews
Dharwadkar Sachin, Manohar ChikkaMoga Siddaiah, Karthikeyan Vilvapathy Senguttuvan, Ratkal Chandrashekar Sidaramappa, Keshavamurthy Ramaiah
PURPOSE: De novo erectile dysfunction (ED) is a known complication after urethroplasty. Incidence and natural history of de novo ED after urethroplasty is underreported. We assessed the incidence of de novo ED after urethroplasty. MATERIALS AND METHODS: Consecutive consenting urethroplasty (n=48) patients aged 21 to 50 years from February 2014 to July 2016 with normal preoperative erectile function as determined by an International Index of Erectile Function-5 (IIEF-5) score ≥22 were included and interviewed at 3, 6, and 12 months...
August 2017: World Journal of Men's Health
Hong Xie, Chao Li, Yue-Min Xu, Chao Feng, Xiang-Guo Lv, Lei Chen, Hong-Bin Li, Jing-Dong Xue
OBJECTIVE: To evaluate the urinary outcomes and preservation of erectile function in patients with pelvic fracture-related urethral injury (PFUI) after nontransecting spongiosum anastomotic urethroplasty (NTSAU). MATERIALS AND METHODS: Fifty-nine male patients with PFUI following traumatic pelvic fracture underwent NTSAU. Inclusion criteria were age 18-60 years, posterior urethral stenosis <2.5 cm without previous urethroplasty, and intact erectile function...
November 2017: Urology
Fikret Fatih Önol, Ahmet Bindayi, Ahmet Tahra, Ismail Basibuyuk, Sinasi Yavuz Onol
AIMS: We validated a Turkish language version of the urethral stricture surgery specific patient-reported outcome measure (USS-PROM) in men undergoing anterior urethroplasty. We also investigated changes in erectile function (EF) and quality of life (QoL) due to oral mucosa graft (OMG) harvesting. METHODS: The USS-PROM captures lower urinary tract symptoms (LUTS), health related QoL (HRQoL) with EQ-5D visual analogue scale (EQ-VAS). To evaluate EF and OMG morbidity, we used International Index of Erectile Function (IIEF-5) and a self-completed questionnaire, respectively...
November 2017: Neurourology and Urodynamics
Conrad C Maciejewski, Trevor Haines, Keith F Rourke
OBJECTIVE: To identify factors that predict patient satisfaction after urethroplasty by prospectively examining patient-reported quality of life scores using 3 validated instruments. METHODS: A 3-part prospective survey consisting of the International Prostate Symptom Score (IPSS), the International Index of Erectile Function (IIEF) score, and a urethroplasty quality of life survey was completed by patients who underwent urethroplasty preoperatively and at 6 months postoperatively...
May 2017: Urology
Soumya Mondal, Anindya Bandyopadhyay, Murari Mohan Mandal, Dilip Kumar Pal
BACKGROUND: Relation of erectile dysfunction (ED) with urethroplasty has long been a subject of debate. Very few studies on subcontinent population are available in this regard and still rarer are studies assessing vascular parameters of ED following urethroplasty. The objective of the study was to assess the incidence and prevalence of ED in patients of urethral stricture disease, and to find out effect of urethroplasty on ED after six months of operation including vasculogenic aetiology after operation...
October 2016: Medical Journal, Armed Forces India
Trevor Haines, Keith F Rourke
PURPOSE: To prospectively assess the effect of urethral transection on erectile function after anterior urethroplasty. METHODS: From February 2012 to December 2014, 104 patients were enrolled in a prospective study assessing erectile function (EF) after anterior urethroplasty. Participants completed the International Index of Erectile Function (IIEF) questionnaire preoperatively and 6 months postoperatively. Outcome measures were the incidence of erectile dysfunction (ED) defined by ≥5-point change in EF and mean change in the EF domain...
May 2017: World Journal of Urology
Rama Firmanto, Gampo A Irdam, Irfan Wahyudi
AIM: this meta-analysis study will evaluate the incidence of urethral stricture as a successfull parameter in the management of PFUI through early realignment, compared with delayed urethroplasty. Long-term complications such as erectile dysfunction and incontinence on both methods will also be evaluated. METHODS: online literature was sourced from Pubmed, Embase, Cochrane, and Google Scholar. The incidence of stricture was evaluated from the entire study group of ER and DU...
April 2016: Acta Medica Indonesiana
Clemens M Rosenbaum, Marianne Schmid, Tim A Ludwig, Luis A Kluth, Roland Dahlem, Margit Fisch, Sascha Ahyai
OBJECTIVES: To determine the success rate, oral morbidity and functional outcomes of redo buccal mucosa graft urethroplasty (BMGU) for treatment of stricture recurrence after previous BMGU. PATIENTS AND METHODS: We included 50 patients who underwent redo BMGU between February 2009 and September 2014. Patients' charts and non-validated questionnaires were reviewed. The primary endpoint was success rate, defined as stricture-free survival. Stricture recurrence was defined as any postoperative claims of catheterization, dilatation, urethrotomy or repeat urethroplasty, or a maximum urinary flow rate <15 mL/s, and a stricture was consecutively verified in a combined cysto-urethrogram or cystoscopy at annual follow-up visit...
November 2016: BJU International
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