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Published in: World Journal of Urology 4/2019

01-04-2019 | Topic Paper

Management of post TURP strictures

Authors: Sanjay B. Kulkarni, Omkar Joglekar, Mohammad Alkandari, Pankaj M. Joshi

Published in: World Journal of Urology | Issue 4/2019

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Abstract

Introduction

Urethral stricture is a well-known complication after transurethral surgeries. The incidence of urethral stricture after transurethral resection of prostate (TURP) varies between 2.2 and 9.8%. Most of the cases present within 6 months of transurethral surgery. Presentation is likely with poor flow, urinary tract infection or acute retention.

Materials and methods

A prospective study was undertaken from January 2010–June 2017 for the management of post TURP stricture. A total of 170 patients with stricture urethra due to TURP were studied.

Results

The age of patients was 54–87 years (mean age 67.34). The mean preop Qmax was 6.1 ml (range 0–15). The length of stricture varied from very short in the proximal bulbar to pan urethral stricture. Out of 170, 94 were treated with dorsal approach, 71 with ventral approach and 5 with simultaneous distal dorsal, proximal ventral approach. Five patients underwent endoscopic procedure. Mean BMG length was 6.25 cm (4–8) and width was 1.5 cm (1.3–1.8). Overall success rate was 82.43%.

Conclusion

Urethral stricture is a well-known complication after transurethral surgeries. Post TURP can cause stricture at any part urethra. BMG mucosa Urethroplasty is the safe, feasible and offer long-term success in these patient and should be strongly considered over CIC and VIU. Ventral approach is best suited for proximal bulbar strictures close to membranous urethra. This is a continence preserving surgery.
Literature
1.
go back to reference Nielsen KK, Norgling J (1990) Urethral stricture following transurethral prostatectomy. Urology 35:18–25CrossRefPubMed Nielsen KK, Norgling J (1990) Urethral stricture following transurethral prostatectomy. Urology 35:18–25CrossRefPubMed
2.
go back to reference Chung JH, Kang DH, Moon HS, Jeong TY, US Ha, JH Han et al (2013) Effects of hyaluronic acid and carboxymethylcellulose on urethral stricture after transurethral resections of the prostate for benign prostatic hyperplasia: a multicenter, single blinded, randomized controlled study. J Endourol 27(4):463–469CrossRefPubMed Chung JH, Kang DH, Moon HS, Jeong TY, US Ha, JH Han et al (2013) Effects of hyaluronic acid and carboxymethylcellulose on urethral stricture after transurethral resections of the prostate for benign prostatic hyperplasia: a multicenter, single blinded, randomized controlled study. J Endourol 27(4):463–469CrossRefPubMed
3.
go back to reference Bissada NK (1977) Transurethral resection of prostate via perineal urethrostomy: follow up and report. Urology 10:39CrossRefPubMed Bissada NK (1977) Transurethral resection of prostate via perineal urethrostomy: follow up and report. Urology 10:39CrossRefPubMed
4.
go back to reference Emmett JL et al (1963) Preliminary internal urethrotomy in 1036 cases to prevent urethral stricture following transurethral resection; calibre of normal adult male urethra. J Urol 89:829CrossRef Emmett JL et al (1963) Preliminary internal urethrotomy in 1036 cases to prevent urethral stricture following transurethral resection; calibre of normal adult male urethra. J Urol 89:829CrossRef
5.
go back to reference Kulkarni S (2012) Post TURP complications and mangement. In: Ramalingam M, Albala DM (eds) Benign prostatic hyperplasia. Macmillan, New York, pp 254–262 Kulkarni S (2012) Post TURP complications and mangement. In: Ramalingam M, Albala DM (eds) Benign prostatic hyperplasia. Macmillan, New York, pp 254–262
6.
go back to reference Barbagli G, Palminteri E, Lazzeri M (2002) Dorsal onlay techniques for urethroplasty. Urol Clin North Am 29(2):389–395CrossRefPubMed Barbagli G, Palminteri E, Lazzeri M (2002) Dorsal onlay techniques for urethroplasty. Urol Clin North Am 29(2):389–395CrossRefPubMed
7.
go back to reference Kulkarni S, Barbagli G, Sansalone S, Lazzeri M (2009) One-sided anterior urethroplasty: a new dorsal onlay graft technique. BJUI 104(8):1150–1155CrossRef Kulkarni S, Barbagli G, Sansalone S, Lazzeri M (2009) One-sided anterior urethroplasty: a new dorsal onlay graft technique. BJUI 104(8):1150–1155CrossRef
8.
go back to reference Morey A, Mc Aninch JW (1996) When and how to use buccal mucosa grafts in urethroplasty. Urology 48(2):194–198CrossRefPubMed Morey A, Mc Aninch JW (1996) When and how to use buccal mucosa grafts in urethroplasty. Urology 48(2):194–198CrossRefPubMed
9.
go back to reference Turner-Warwick R (1986) The principles of urethral reconstruction. In: Williams DI (ed) Operative surgery: urology. Butterworth, London, pp 480–520 (Rob and Smith’s Operative Suregry, 4th edn) Turner-Warwick R (1986) The principles of urethral reconstruction. In: Williams DI (ed) Operative surgery: urology. Butterworth, London, pp 480–520 (Rob and Smith’s Operative Suregry, 4th edn)
Metadata
Title
Management of post TURP strictures
Authors
Sanjay B. Kulkarni
Omkar Joglekar
Mohammad Alkandari
Pankaj M. Joshi
Publication date
01-04-2019
Publisher
Springer Berlin Heidelberg
Published in
World Journal of Urology / Issue 4/2019
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI
https://doi.org/10.1007/s00345-018-2498-x

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