Treatment of recurring urethral strictures in men using human amniotic membranes
Article published in Urologia Polska 2007/60/3.

authors

Adam Marcheluk, Andrzej Koziak, Jan Taczalski, Telesfor Saracyn, Marek Sosnowski: Oddział Urologiczny im. Prof. Tadeusza Krzeskiego Wojewódzkiego Szpitala Specjalistycznego w Siedlcach
Oddział Urologiczny Wojewódzkiego Szpitala Specjalistycznego w Zgierzu
Oddział Urologiczny Wojewódzkiego Szpitala Specjalistycznego w Łomży
I Klinika i Katedra Urologii Uniwersytetu Medycznego w Łodzi

keywords

urethral, male urethra stricture, male urethra reconstruction, human amnion

summary

Introduction. Problem of recurrent urethra strictures in men induces to look for new operating techniques, more effective than internal optical urethrotomy (IOU) in long term follow-up. The aim of the study. Comparison of treatment efficacy between IOU and reconstructive surgery using human amnion in management of recurrent male urethra strictures.

Material and methods. Two groups of men aged 27 to 80 years, with recurrent urethra stricture were operated in years 2001-2006. Investigated group (IG) – 25 men operated using authors method; dissection of strictured urethra, incision of the narrowed part and coverage with human amniotic membrane. The control group (CG) underwent IOU – 32 men. In all of the cases flow rates, imaging and endoscopic survey were performed before and during 3, 6, 12, 24 and 36 month after surgery. Stricture length ranged between 1.5 and 6 (mean 2.82) cm in IG, versus 1-2 (mean 1.1) cm in the CG. Most common localization of stricture was in IG penile urethra – 13 patients (44.8%), in CG – bulbous urethra – 22 patients (68.7%). The data were statistically analyzed

Results. In all cases the perioperative period was without significant complications. Average time after hospitalization was 9.6 (IG) and 1.2 days (CG). Increase in maximum flow parameters after 3 months – in 13 ml/s (IG), in 2 ml/s (CG). In subsequent months flow parameters in CG decreased or urinary retention occurred. No flow parameters decrease was observed in long term follow-up in IG. In the IG in 3 (12%), and in CG in 26 (81,2% recurrence rate) cases restenosis was observed. Conclusions. Presented technique allows to manage recurrent male urethra strictures in an effective way. This method/technique is more effective than OIU in long term follow-up.

references

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