1/17. balanitis xerotica obliterans with urethral stricture after hypospadias repair.Three cases of urethral stricture due to balanitis xerotica obliterans (BXO) after hypospadias repair are reported. The first patient showed white, dense scarring on the prepuce before the hypospadias repair and developed a stricture of the urethra after the operation. The second and the third were uneventful for 6 and 2 years, respectively, after the hypospadias repair, and then developed urethral strictures. Pathologic diagnosis of the stenotic lesion is essential. Complete excision of the affected urethra with topical steroid ointment or sublesional triamcinolone injection is recommended for this condition. Although the complication of BXO after hypospadias repair is rare (3 out of 796 cases with hypospadias in our series), surgeons need to be aware of this condition as a cause for late onset of urethral problems.- - - - - - - - - - ranking = 1keywords = urethral stricture, stricture (Clic here for more details about this article) |
2/17. Recurrent urethral hairball and stone in a hypospadiac: management and prevention.A 32-year-old perineal hypospadiac man presented with recurrent urethral hair growth, stone, and stricture with a history of multiple urethroplasties. He was treated by urethrolithotomy, internal urethrotomy, laser epilation of the hair-bearing urethral graft, closure of the fistula, and chemical depilation of the neourethral hair. A dilute solution of thioglycolate was prophylactically instilled into the neourethra at intervals of 3 months to ensure complete tricholysis and to prevent recurrent hair growth in the future.- - - - - - - - - - ranking = 0.00073987740953658keywords = stricture (Clic here for more details about this article) |
3/17. Urethral substitution using an intestinal free flap: a novel approach.PURPOSE: patients who have extensive stricture disease, those in whom hypospadias repair fails and those who sustain significant urethral trauma pose a reconstructive challenge for genitourinary surgeons. We developed an additional reconstructive option for men with a severely diseased urethra when grafting procedures and local tissue flaps have failed or are otherwise contraindicated. MATERIALS AND methods: A genitourinary reconstructive team performed novel intestinal free flap substitution urethroplasty in 2 patients. A segment of jejunum is harvested on a vascular pedicle and plicated into an appropriate size urethral substitute. Microvascular anastomoses allow this segment to remain viable and functional. The technical aspects of repair and surgical considerations are detailed. RESULTS: The 2 patients have a satisfactory functional and cosmetic outcome. At short followup the urethral lumen remained patent and the intestinal urethra remained viable and intact. Both patients have good urinary streams and are able to void in the standing position. CONCLUSIONS: This initial experience in 2 patients indicates that intestinal segment urethral substitution may be considered within the reconstructive armamentarium of genitourinary surgeons when more conventional options have failed or are contraindicated. Continued vigilant followup is necessary to detail any secondary complications. In addition, further experience with this technique by other surgeons would help determine its overall usefulness.- - - - - - - - - - ranking = 0.00073987740953658keywords = stricture (Clic here for more details about this article) |
4/17. Buccal mucosal graft for urethral reconstruction.Urethral reconstruction with graft substances, such as skin and bladder mucosa, has been previously used when primary anastomosis cannot be achieved. However, stricture and meatal prolapse are associated with these grafts. We report the use of buccal mucosa for the reconstruction of urethral defects in 3 patients. One patient with failed operation for hypospadias received tube buccal mucosal graft for urethral replacement. Two patients with urethral necrosis and stricture received onlay buccal mucosal graft. All patients were disease-free during follow-up (range, 12 to 49 months; mean, 36 months). One patient had a pinhole fistula that was successfully managed with simple repair. This technique appears to be useful for urethral reconstruction when a local graft is not available, even in patients with complicated conditions.- - - - - - - - - - ranking = 0.0014797548190732keywords = stricture (Clic here for more details about this article) |
5/17. Pseudohypospadias with bilateral vesicoureteric reflux: consequences of inappropriate management of stricture urethra.A 17-year-old male boy presented with clinical features of pseudohypospadias (small penile stump with absent distal penile urethra) associated with very small capacity bladder and bilateral grade IV vesicoureteric reflux following suprapubic urinary diversion for multiple urethro-cutaneous fistula and periurethral abscess which developed as a consequence of inappropriate initial management of urethral trauma. This case highlights the importance of the initial management of urethral trauma and the management of its rare complication.- - - - - - - - - - ranking = 0.0029595096381463keywords = stricture (Clic here for more details about this article) |
6/17. hypospadias repair in elderly patients.Although surgical repair of hypospadias has been performed for decades, some older men with this anomaly have never been treated or even referred. Age alone should not be a contraindication for surgery. Rather, the physician needs to consider the degree of urethral stricture and voiding impairment caused by the disorder and the extent those factors affect the patient's quality of life.- - - - - - - - - - ranking = 0.16654335376508keywords = urethral stricture, stricture (Clic here for more details about this article) |
7/17. Pan-urethral strictures can develop as a complication of UroLume placement for bulbar stricture disease in patients with hypospadias.We report the development of pan-urethral strictures in 2 patients with hypospadias who underwent UroLume urethral stent placement for bulbar urethral stricture disease before referral to our institution. To our knowledge, this devastating complication has never previously been reported. The likely etiology was ischemic urethral stenosis secondary to occlusion of bulbar arteries, the dominant urethral blood supply in hypospadias patients who lack a secondary retrograde blood supply through the glans penis. We conclude that hypospadias should be an absolute contraindication to urethral stent placement.- - - - - - - - - - ranking = 1.002227545036keywords = urethral stricture, stricture, stenosis (Clic here for more details about this article) |
8/17. Total laryngotracheal hypoplasia in a case of G syndrome.We report a case of congenital hypoplasia of the larynx and trachea in the presence of an essentially normal cartilaginous structure. To our knowledge this abnormality is not recognised in the literature. Previously reported hypoplastic laryngeal anomalies have all shown anatomical defects ranging from clefts to atresia (Smith and Bain 1965, Gatti et al., 1987). Similarly total congenital tracheal stenosis is accompanied by abnormalities of the cartilaginous structure, usually complete tracheal rings. These types of anomaly typically present either at, or soon after, birth and are associated with other congenital abnormalities. In this particular case the laryngotracheal hypoplasia occurred in the context of a herditary condition of multiple congenital abnormalities known as G syndrome (also known as Opitz-Frias syndrome or the Opitz-G syndrome).- - - - - - - - - - ranking = 7.912807366164E-6keywords = stenosis (Clic here for more details about this article) |
9/17. hypospadias repair by bladder mucosal graft: an initial report.Surgical correction of major hypospadias defects is a challenging problem. Bladder mucosa has been reported as an excellent tissue for construction of a neourethra. We used bladder mucosa in 13 boys to create 15 neourethras when there was inadequate preputial skin to perform a vascularized pedicle flap or a free preputial graft. In 3 cases a bladder mucosa graft was used for initial repair of the hypospadias. All other boys had undergone prior hypospadias surgery. In 4 boys the initial result was satisfactory. Seven minor complications occurred in 5 boys, while 4 had more major complications. In 2 boys severe problems with stricture necessitated graft replacement and a satisfactory outcome has not been achieved. Our problems with stricture and stenosis seem to be related to the use of a subcutaneous tunnel for the graft bed and coring of the glans to create the meatus. Over-all, in 11 of the 13 boys the bladder mucosal graft provided an excellent resolution of the complex problem with easily managed postoperative complications.- - - - - - - - - - ranking = 0.0014876676264393keywords = stricture, stenosis (Clic here for more details about this article) |
10/17. Urethroplasty using diverticular tissue.Diverticula that occur in the neourethra following repair of hypospadias, epispadias or urethral stricture generally are associated with obstruction distal to the dilated segment. This diverticular tissue can be moderately elastic and well vascularized. We have been able to relieve the stenosis by developing and advancing a diverticular flap, simultaneously reducing the size of the diverticulum.- - - - - - - - - - ranking = 0.16655126657244keywords = urethral stricture, stricture, stenosis (Clic here for more details about this article) |
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