Quality of life of men after various methods of operative treatment for urethral stricture

Quality of life of patients was the best after substitution buccal urethroplasty and Turner-Warwick modified by Webster anastomotic urethroplasty, than after internal optical urethrotomy. It is caused by high frequency of recurrence of urethral stricture after internal optical urethrotomy that dictates necessity of its use only at strict indications.</em

Results of use of fibrin glue for surgical treatment of urethral stricture

Influence of fibrin glue on results of surgical treatment of urethral stricture in experience with 32 rats and in clinic at 65 men is investigated. Glue use has led to significant reduction of operative time, tightness increase of an anastomotic seam, to reduction of catheterisation duration terms and to decrease in frequency of recurrence of urethral stricture.</em

Comparative rate and risk factors of recurrent urethral stricture during different surgical procedures

Objective – to identify the major risk factors leading to worse results of surgical treatment in patients with urethral stricture.Subjects and methods. Two hundred and forty-eight patients with urethral stricture underwent different surgical interventions: internal optical urethrotomy (IOU) for strictures of different portions of the urethra in 157 patients (the operation was made once in 121 patients, twice in 24 patients, and thrice or more in 12); replacement urethroplasty using a buccal mucosa graft for strictures of the anterior urethra in 46 patients; Turner-Warwick’s anastomotic urethroplasty modified by Webster for strictures (distraction defects) of the posterior urethra in 45 patients. The results of surgical treatment were studied using urethrography, uroflowmetry, urethrocystoscopy, the international prostate symptom score, quality of life (QoL) questionnaire, and the international index of erectile function (IIEF) questionnaire. The role of risk factors for postoperative recurrent urethral stricture was assessed by univariate and multivariate analyses.Results. The rate of recurrent urethral stricture after IOU was 66.9 % (59.5, 87.5, and 100 % after the first, second, third or more subsequent operations, respectively; 12.1 % after all types of urethroplasty, 15.2 % after augmentation urethroplasty, and 8.9 % after anastomotic urethroplasty. The major risk factors of recurrent urethral stricture after IOU were recognized to be the location of urethral stricture in the penile or bulbomembranous portions, a urethral stricture length of &gt; 1 cm, severe urethral lumen narrowing, and performance of 2 or more operations; those after augmentation urethroplasty were previous ineffective treatment, a stricture length of &gt; 4 cm, lichen sclerosus, and smoking; those after anastomotic urethroplasty were previous ineffective treatment, smoking, and a stricture length of &gt; 4 cm.Conclusion. The results of the investigation have shown that only pathogenetically grounded treatments for stricture allow their high efficiency to be achieved.</em