![]() ![]() The preoperative evaluation consisted of combined antegrade and retrograde cystourethrograms and cystourethrography. The median time from injury to surgical repair was 12 months. In all cases, the area of fibrosis was aggressively excised, the corpus spongiosum was mobilized, and a tension-free, spatulated end-to-end anastomosis was achieved by splitting the corporeal bodies in 66.2% and by an additional perineally performed inferior pubectomy in 49.3% of the patients. A total of 77 men with posterior urethral distraction injury due to pelvic trauma underwent reconstruction with delayed perineal approach. ![]() In this report, we review our experience with delayed perineal urethral reconstruction, with a focus on the long-term outcome and complications. Initial suprapubic cystostomy and delayed perineal urethral reconstruction has been considered the reference standard. There is still controversy regarding the treatment of post-traumatic posterior urethral distraction injuries. ![]() We suggest a regular, simple urethral dilation protocol for patients with recurrent bulbomembranous urethral stricture shorter than 2 cm, because this significantly allays the stricture recurrence rate, possibly eliminates the need for consecutive DVIU, and reduces morbidity. The mean maximal urinary flow rate in groups 1 and 2 at last follow-up was 7.8 ± 3.7 and 21.0 ± 8.7 mL/s, respectively ( P <0.01).Ĭonclusions. During the same follow-up period, recurrence was observed in 2 patients (10.5%), 9 months and 2 years after randomization, in group 2 ( P <0.05). After a median follow-up of 30 months, the urethral stricture recurred within 12 months in 55.6% (n = 10) of group 1, and consecutive DVIUs were indicated. In group 2 (n = 19), patients received urethral dilations with Benique dilatators (maximal 21F) under intraurethral anesthesia, beginning 10 days after the initial internal urethrotomy, according to the following protocol: weekly for the first month, once after 3 and after 6 months, and then once each year. In group 1 (n = 18), the patients were observed by regular visits and uroflowmetry profiles after the initial DVIU and consecutive DVIUs were considered when the stricture recurred. The etiology and location of the strictures were similar, and their length ranged from 0.5 to 2 cm in each group. A total of 37 patients, who had undergone at least two DVIUs to treat their recurrent urethral strictures, were enrolled in this study. To compare the outcome of patients who underwent direct vision internal urethrotomy (DVIU) and then followed a protocol that randomized them to either our urethral dilation protocol or consecutive DVIUs for the treatment of their urethral stricture. The high recurrence rate is still the major complication of endoscopic treatment of urethral stricture disease. ![]()
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