Endoscopic Urethroplasty Using Buccal Graft for Male Membranous Urethral Stricture
To demonstrate a new minimally invasive endoscopic approach to urethroplasty. The procedure was performed in a male patient with prior history of prostate cancer managed by radiation who subsequently developed an 8 mm flow-limiting membranous urethral stricture. After stricture dilation a 1 cm wide...
Gespeichert in:
Veröffentlicht in: | Urology (Ridgewood, N.J.) N.J.), 2023-11, Vol.181, p.e200-e203 |
---|---|
Hauptverfasser: | , , , , |
Format: | Artikel |
Sprache: | eng |
Schlagworte: | |
Online-Zugang: | Volltext |
Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
container_end_page | e203 |
---|---|
container_issue | |
container_start_page | e200 |
container_title | Urology (Ridgewood, N.J.) |
container_volume | 181 |
creator | Ungerer, Garrett Kemble, Jayson Sischka, Michael Balzano, Felicia L. Warner, Jonathan N. |
description | To demonstrate a new minimally invasive endoscopic approach to urethroplasty.
The procedure was performed in a male patient with prior history of prostate cancer managed by radiation who subsequently developed an 8 mm flow-limiting membranous urethral stricture. After stricture dilation a 1 cm wide strip of superficial mucosa was resected from the bladder neck past the area of stricture, creating a bed for the graft to lay. Buccal mucosa graft was harvested in standard fashion. With the graft outside the urethra and using the RD 180 endoscopic suturing device, a suture is placed in the proximal end of the graft, then through the bladder neck, and back through the graft. As the suture is pulled, the pulley phenomenon advances the graft into place on the bladder neck. The graft is then anchored to the posterior urethra with secure straps. A catheter is placed to hold the graft flat during the healing process.
The procedure lasted 2.5 hours without any complications. Estimated blood loss was 50cc, and the patient was discharged after the procedure. Catheter was removed at 4weeks. Cystoscopy at 10weeks post-op showed good graft viability, with peak flow improving to 20 mL/s compared to 4 mL/s preoperatively. At 6months, he continues to do well without evidence of recurrent urethral stricture.
Endoscopic urethroplasty using buccal graft appears to offer a safe and effective repair option for management of ureteral strictures. |
doi_str_mv | 10.1016/j.urology.2023.05.059 |
format | Article |
fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2845657283</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0090429523006520</els_id><sourcerecordid>2845657283</sourcerecordid><originalsourceid>FETCH-LOGICAL-c313t-daaaf2fa59fdb6c8e6a2039e2e17baff3db294e72f0be7fc862f085f3ccf31213</originalsourceid><addsrcrecordid>eNqFkF1LwzAUhoMobk5_gtJLb1rzsbTNleiYU9gQ1F2HND2ZGV0zk1bYvzdj01vhhXMunvd8vAhdE5wRTPK7ddZ717jVLqOYsgzzKHGChoTTIhVC8FM0xFjgdEwFH6CLENYY4zzPi3M0YAVnFJfFEL1N29oF7bZWJ0sP3ad320aFbpcsg21XyWOvtWqSmVemS4zzyUI1kCxgU3nVuj4cTRF577zVXe_hEp0Z1QS4OtYRWj5NPybP6fx19jJ5mKeaEdaltVLKUKO4MHWV6xJyRTETQIEUlTKG1RUVYyiowRUURpd57EpumNaGEUrYCN0e5m69--ohdHJjg4amUS3EyyQtxzznBS1ZRPkB1d6F4MHIrbcb5XeSYLmPU67lMU65j1NiHiWi7-a4oq82UP-5fvOLwP0BgPjotwUvg7bQaqitB93J2tl_VvwAgRCLdg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2845657283</pqid></control><display><type>article</type><title>Endoscopic Urethroplasty Using Buccal Graft for Male Membranous Urethral Stricture</title><source>MEDLINE</source><source>Access via ScienceDirect (Elsevier)</source><creator>Ungerer, Garrett ; Kemble, Jayson ; Sischka, Michael ; Balzano, Felicia L. ; Warner, Jonathan N.</creator><creatorcontrib>Ungerer, Garrett ; Kemble, Jayson ; Sischka, Michael ; Balzano, Felicia L. ; Warner, Jonathan N.</creatorcontrib><description>To demonstrate a new minimally invasive endoscopic approach to urethroplasty.
The procedure was performed in a male patient with prior history of prostate cancer managed by radiation who subsequently developed an 8 mm flow-limiting membranous urethral stricture. After stricture dilation a 1 cm wide strip of superficial mucosa was resected from the bladder neck past the area of stricture, creating a bed for the graft to lay. Buccal mucosa graft was harvested in standard fashion. With the graft outside the urethra and using the RD 180 endoscopic suturing device, a suture is placed in the proximal end of the graft, then through the bladder neck, and back through the graft. As the suture is pulled, the pulley phenomenon advances the graft into place on the bladder neck. The graft is then anchored to the posterior urethra with secure straps. A catheter is placed to hold the graft flat during the healing process.
The procedure lasted 2.5 hours without any complications. Estimated blood loss was 50cc, and the patient was discharged after the procedure. Catheter was removed at 4weeks. Cystoscopy at 10weeks post-op showed good graft viability, with peak flow improving to 20 mL/s compared to 4 mL/s preoperatively. At 6months, he continues to do well without evidence of recurrent urethral stricture.
Endoscopic urethroplasty using buccal graft appears to offer a safe and effective repair option for management of ureteral strictures.</description><identifier>ISSN: 0090-4295</identifier><identifier>EISSN: 1527-9995</identifier><identifier>DOI: 10.1016/j.urology.2023.05.059</identifier><identifier>PMID: 37532087</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Constriction, Pathologic ; Cystoscopy ; Humans ; Male ; Urethra - surgery ; Urethral Stricture - etiology ; Urethral Stricture - surgery ; Urinary Bladder</subject><ispartof>Urology (Ridgewood, N.J.), 2023-11, Vol.181, p.e200-e203</ispartof><rights>2023 Elsevier Inc.</rights><rights>Copyright © 2023 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c313t-daaaf2fa59fdb6c8e6a2039e2e17baff3db294e72f0be7fc862f085f3ccf31213</cites><orcidid>0000-0002-9839-7151</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37532087$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ungerer, Garrett</creatorcontrib><creatorcontrib>Kemble, Jayson</creatorcontrib><creatorcontrib>Sischka, Michael</creatorcontrib><creatorcontrib>Balzano, Felicia L.</creatorcontrib><creatorcontrib>Warner, Jonathan N.</creatorcontrib><title>Endoscopic Urethroplasty Using Buccal Graft for Male Membranous Urethral Stricture</title><title>Urology (Ridgewood, N.J.)</title><addtitle>Urology</addtitle><description>To demonstrate a new minimally invasive endoscopic approach to urethroplasty.
The procedure was performed in a male patient with prior history of prostate cancer managed by radiation who subsequently developed an 8 mm flow-limiting membranous urethral stricture. After stricture dilation a 1 cm wide strip of superficial mucosa was resected from the bladder neck past the area of stricture, creating a bed for the graft to lay. Buccal mucosa graft was harvested in standard fashion. With the graft outside the urethra and using the RD 180 endoscopic suturing device, a suture is placed in the proximal end of the graft, then through the bladder neck, and back through the graft. As the suture is pulled, the pulley phenomenon advances the graft into place on the bladder neck. The graft is then anchored to the posterior urethra with secure straps. A catheter is placed to hold the graft flat during the healing process.
The procedure lasted 2.5 hours without any complications. Estimated blood loss was 50cc, and the patient was discharged after the procedure. Catheter was removed at 4weeks. Cystoscopy at 10weeks post-op showed good graft viability, with peak flow improving to 20 mL/s compared to 4 mL/s preoperatively. At 6months, he continues to do well without evidence of recurrent urethral stricture.
Endoscopic urethroplasty using buccal graft appears to offer a safe and effective repair option for management of ureteral strictures.</description><subject>Constriction, Pathologic</subject><subject>Cystoscopy</subject><subject>Humans</subject><subject>Male</subject><subject>Urethra - surgery</subject><subject>Urethral Stricture - etiology</subject><subject>Urethral Stricture - surgery</subject><subject>Urinary Bladder</subject><issn>0090-4295</issn><issn>1527-9995</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkF1LwzAUhoMobk5_gtJLb1rzsbTNleiYU9gQ1F2HND2ZGV0zk1bYvzdj01vhhXMunvd8vAhdE5wRTPK7ddZ717jVLqOYsgzzKHGChoTTIhVC8FM0xFjgdEwFH6CLENYY4zzPi3M0YAVnFJfFEL1N29oF7bZWJ0sP3ad320aFbpcsg21XyWOvtWqSmVemS4zzyUI1kCxgU3nVuj4cTRF577zVXe_hEp0Z1QS4OtYRWj5NPybP6fx19jJ5mKeaEdaltVLKUKO4MHWV6xJyRTETQIEUlTKG1RUVYyiowRUURpd57EpumNaGEUrYCN0e5m69--ohdHJjg4amUS3EyyQtxzznBS1ZRPkB1d6F4MHIrbcb5XeSYLmPU67lMU65j1NiHiWi7-a4oq82UP-5fvOLwP0BgPjotwUvg7bQaqitB93J2tl_VvwAgRCLdg</recordid><startdate>202311</startdate><enddate>202311</enddate><creator>Ungerer, Garrett</creator><creator>Kemble, Jayson</creator><creator>Sischka, Michael</creator><creator>Balzano, Felicia L.</creator><creator>Warner, Jonathan N.</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-9839-7151</orcidid></search><sort><creationdate>202311</creationdate><title>Endoscopic Urethroplasty Using Buccal Graft for Male Membranous Urethral Stricture</title><author>Ungerer, Garrett ; Kemble, Jayson ; Sischka, Michael ; Balzano, Felicia L. ; Warner, Jonathan N.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c313t-daaaf2fa59fdb6c8e6a2039e2e17baff3db294e72f0be7fc862f085f3ccf31213</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Constriction, Pathologic</topic><topic>Cystoscopy</topic><topic>Humans</topic><topic>Male</topic><topic>Urethra - surgery</topic><topic>Urethral Stricture - etiology</topic><topic>Urethral Stricture - surgery</topic><topic>Urinary Bladder</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ungerer, Garrett</creatorcontrib><creatorcontrib>Kemble, Jayson</creatorcontrib><creatorcontrib>Sischka, Michael</creatorcontrib><creatorcontrib>Balzano, Felicia L.</creatorcontrib><creatorcontrib>Warner, Jonathan N.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Urology (Ridgewood, N.J.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ungerer, Garrett</au><au>Kemble, Jayson</au><au>Sischka, Michael</au><au>Balzano, Felicia L.</au><au>Warner, Jonathan N.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Endoscopic Urethroplasty Using Buccal Graft for Male Membranous Urethral Stricture</atitle><jtitle>Urology (Ridgewood, N.J.)</jtitle><addtitle>Urology</addtitle><date>2023-11</date><risdate>2023</risdate><volume>181</volume><spage>e200</spage><epage>e203</epage><pages>e200-e203</pages><issn>0090-4295</issn><eissn>1527-9995</eissn><abstract>To demonstrate a new minimally invasive endoscopic approach to urethroplasty.
The procedure was performed in a male patient with prior history of prostate cancer managed by radiation who subsequently developed an 8 mm flow-limiting membranous urethral stricture. After stricture dilation a 1 cm wide strip of superficial mucosa was resected from the bladder neck past the area of stricture, creating a bed for the graft to lay. Buccal mucosa graft was harvested in standard fashion. With the graft outside the urethra and using the RD 180 endoscopic suturing device, a suture is placed in the proximal end of the graft, then through the bladder neck, and back through the graft. As the suture is pulled, the pulley phenomenon advances the graft into place on the bladder neck. The graft is then anchored to the posterior urethra with secure straps. A catheter is placed to hold the graft flat during the healing process.
The procedure lasted 2.5 hours without any complications. Estimated blood loss was 50cc, and the patient was discharged after the procedure. Catheter was removed at 4weeks. Cystoscopy at 10weeks post-op showed good graft viability, with peak flow improving to 20 mL/s compared to 4 mL/s preoperatively. At 6months, he continues to do well without evidence of recurrent urethral stricture.
Endoscopic urethroplasty using buccal graft appears to offer a safe and effective repair option for management of ureteral strictures.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>37532087</pmid><doi>10.1016/j.urology.2023.05.059</doi><orcidid>https://orcid.org/0000-0002-9839-7151</orcidid></addata></record> |
fulltext | fulltext |
identifier | ISSN: 0090-4295 |
ispartof | Urology (Ridgewood, N.J.), 2023-11, Vol.181, p.e200-e203 |
issn | 0090-4295 1527-9995 |
language | eng |
recordid | cdi_proquest_miscellaneous_2845657283 |
source | MEDLINE; Access via ScienceDirect (Elsevier) |
subjects | Constriction, Pathologic Cystoscopy Humans Male Urethra - surgery Urethral Stricture - etiology Urethral Stricture - surgery Urinary Bladder |
title | Endoscopic Urethroplasty Using Buccal Graft for Male Membranous Urethral Stricture |
url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-23T01%3A43%3A26IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Endoscopic%20Urethroplasty%20Using%20Buccal%20Graft%20for%20Male%20Membranous%20Urethral%20Stricture&rft.jtitle=Urology%20(Ridgewood,%20N.J.)&rft.au=Ungerer,%20Garrett&rft.date=2023-11&rft.volume=181&rft.spage=e200&rft.epage=e203&rft.pages=e200-e203&rft.issn=0090-4295&rft.eissn=1527-9995&rft_id=info:doi/10.1016/j.urology.2023.05.059&rft_dat=%3Cproquest_cross%3E2845657283%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2845657283&rft_id=info:pmid/37532087&rft_els_id=S0090429523006520&rfr_iscdi=true |