Üretra darlıklarında nüks sayısı, darlık uzunluğu ve lokalizasyonu öngören parametreler
Yıl 2023,
, 43 - 49, 31.01.2023
Muhammed Temel
,
Sezgin Okçelik
Öz
Amaç: Bu çalışmada üretral darlıkların bilinen etiyolojik ve predispozan faktörlerine ek olarak, bilinmeyen ve net olarak tanımlanmamış faktörler incelendi.
Gereç ve Yöntem: Merkezimizde 2017-2022 yılları arasında Vizüel internal üretrotom (VIU) operasyonu geçiren 317 hastanın tıbbi kayıtları retrospektif olarak incelendi. Total VIU operasyonu sayısı üzerinde etkili olan parametreler araştırıldı. Ek olarak total dar segment uzunluğuna ve darlık lokalizasyonuna etki eden faktörler araştırıldı.
Bulgular: Geçirilmiş endoürolojik cerrahi öyküsü ve kardiyovasküler hastalık öyküsünün, daha fazla VIU operasyonu sayısı ile ilişkili olduğu görüldü (p<0.05). Yaş, daha uzun total üretral darlık segmentiyle ilişkiliydi (p<0.05). Daha önce geçirilmiş endoürolojik müdahale öyküsü ve kardiyovasküler hastalık hikayesi, darlığın daha distalde olma oranını istatistiksel anlamlı şekilde arttırmaktaydı (p<0.05).
Sonuç: Kardiyovasküler hastalık hikayesi olan kişilerde endoürolojik girişim ve üretral kateter yerleştirilmesi işlemlerinden mümkün olduğunca kaçınılmalıdır. Erektil disfonksiyon hastalarında yapıldığı gibi, anterior üretral darlığı olan hastalarda da kardiyovasküler hastalık araştırmasının yapılması faydalı bir yaklaşım olacaktır.
Kaynakça
- Referans1 Alwaal A, Blaschko SD, McAninch JW, Breyer BN. Epidemiology of urethral strictures. Transl Androl Urol 2018;3(2):209-213. doi:10.3978/j.issn.2223-4683.2014.04.07
- Referans2 Lubahn JD, Zhao LC, Scott JF, Hudak SJ, Chee J, Terlecki R et al. Poor quality of life in patients with urethral stricture treated with intermittent self-dilation. J Urol 2014;191(1):143-147. doi:10.1016/j.juro.2013.06.054
- Referans3 Stein DM, Thum DJ, Barbagli G, Kulkarni S, Sansalone S, Pardeshi A et al. A geographic analysis of male urethral stricture aetiology and location. BJU Int 2013;112(6):830-834. doi:10.1111/j.1464-410X.2012.11600.x
- Referans4 EAU Guidelines. Edn. presented at the EAU Annual Congress Milan 2021. ISBN 978-94-92671-13-4.
- Referans5 Wessells H, Angermeier KW, Elliott S et al: Male urethral stricture: American Urological Association guideline. J Urol 2017;197:182.
- Referans6 Cotter KJ, Hahn AE, Voelzke BB, Myers JB, Smith TG, Elliott SP et al. Trends in Urethral Stricture Disease Etiology and Urethroplasty Technique From a Multi-institutional Surgical Outcomes Research Group. Urology 2019;130:167-174. doi:10.1016/j.urology.2019.01.046
- Referans7 Mundy AR, Andrich DE. Urethral strictures. BJU Int 2011;107(1):6-26. doi: 10.1111/j.1464-410X.2010.09800.x
- Referans8 Yildiz I, Gokalp F, Burak C, Karazindiyanoğlu S, Yildiz PO, Rencuzogullari İ et al. Relationship between the Severity of Coronary Artery Disease and Catheter-Associated Urethral Stricture in Patients with Acute Coronary Syndrome. J Tehran Heart Cent 2020;15(3):113-118. doi:10.18502/jthc.v15i3.4221
- Referans9 Palminteri E, Berdondini E, Verze P, Nunzio CD, Vitarelli A, Carmignani L et al. Contemporary urethral stricture characteristics in the developed world. Urology 2013;81(1):191-196. doi:10.1016/j.urology.2012.08.062
- Referans10 Kizilay F, Şimşir A, Özyurt C. Analysis of recurrent urethral strictures due to iatrogenic urethral trauma. Turk J Med Sci 2017;47(5):1543-1548. doi: 10.3906/sag-1701-36
- Referans11 Meddings J, Saint S, Fowler KE, Gaies E, Hickner A, Krein SL et al. The Ann Arbor Criteria for Appropriate Urinary Catheter Use in Hospitalized Medical Patients: Results Obtained by Using the RAND/UCLA Appropriateness Method. Ann Intern Med 2015;162(9 Suppl):S1-34. doi: 10.7326/M14-1304
- Referans12 Aoki T. Appropriate Use of Urinary Catheter in Acute Heart Failure Patients. Circ J 2018;82(6):1505-1506. doi:10.1253/circj.CJ-18-0447
- Referans13 Latini JM, McAninch JW, Brandes SB, Chung JY, Rosenstein D. SIU/ICUD Consultation On Urethral Strictures: Epidemiology, etiology, anatomy, and nomenclature of urethral stenoses, strictures, and pelvic fracture urethral disruption injuries. Urology 2014;83(3 Suppl):S1-7. doi:10.1016/j.urology.2013.09.009
- Referans14 Niels-Peter B, Riehmann M, Gasser TC. Absence of urethral strictures with suprapubic urinary drainage during extracorporeal circulation. J Urol 1993;150(2):337-339. doi:10.1016/s0022-5347(17)35478-2
- Referans15 Santucci RA, Joyce GF, Wise M. Male urethral stricture disease. J Urol 2007;177(5):1667-1674. doi:10.1016/j.juro.2007.01.041
- Referans16 Levy M, Gor RA, Vanni AJ, Stensland K, Erickson BA, Myers JB et al. The Impact of Age on Urethroplasty Success. Urology 2017;107:232-238. doi: 10.1016/j.urology.2017.03.066
- Referans17 Lumen N, Hoebeke P, Willemsen P, Troyer BD, Pieters R, Oosterlinck W. Etiology of urethral stricture disease in the 21st century. J Urol 2009;182(3):983-987. doi:10.1016/j.juro.2009.05.023
- Referans18 Andrade WS, Oliveira P, Laydner H, Ferreira EJP, Barreto-Filho JAS. Severity of erectile dysfunction is highly correlated with the syntax score in patients undergoing coronariography. Int Braz J Urol 2016;42(1):123-131. doi:10.1590/S1677-5538.IBJU.2015.0002
- Referans19 Hamur H, Duman H, Keskin E, Inci S, Kucuksu Z, Degirmenci H et al. The relation between erectile dysfunction and extent of coronary artery disease in the patients with stable coronary artery disease. Int J Clin Exp Med 2015;8(11):21295-21302; PMID: 26885069
Parameters predicting the number of recurrences, strictural length and localization in urethral strictures
Yıl 2023,
, 43 - 49, 31.01.2023
Muhammed Temel
,
Sezgin Okçelik
Öz
Purpose: In addition to the known etiological and predisposing factors of urethral stricture, we aimed to examine unknown and not clearly defined factors.
Materials and Methods: Medical records of 317 patients who underwent visual internal urethrotome (VIU) surgery in our clinic between 2017 and 2022 were retrospectively reviewed. The effect of other parameters on the total number of VIU operations was investigated. Additionally, the factors affecting the total strictural segment length of urethra and stricture localization were investigated.
Results: The presence of history of endourological surgery and history of cardiovascular disease were independently associated with a higher number of VIU operations (p<0.05). The age was independently associated with longer total urethral stricture segments (p<0.05). The history of previous endourological intervention or the presence of cardiovascular disease are significantly increased the rate of distally localized strictures (p<0.05).
Conclusion: Endourological interventions and urethral catheter procedures should be avoided as much as possible for people with cardiovascular disease. It will be a useful approach to investigate the status of cardiovascular disease of patients with anterior urethral stricture, as It is done in erectile disfunction.
Kaynakça
- Referans1 Alwaal A, Blaschko SD, McAninch JW, Breyer BN. Epidemiology of urethral strictures. Transl Androl Urol 2018;3(2):209-213. doi:10.3978/j.issn.2223-4683.2014.04.07
- Referans2 Lubahn JD, Zhao LC, Scott JF, Hudak SJ, Chee J, Terlecki R et al. Poor quality of life in patients with urethral stricture treated with intermittent self-dilation. J Urol 2014;191(1):143-147. doi:10.1016/j.juro.2013.06.054
- Referans3 Stein DM, Thum DJ, Barbagli G, Kulkarni S, Sansalone S, Pardeshi A et al. A geographic analysis of male urethral stricture aetiology and location. BJU Int 2013;112(6):830-834. doi:10.1111/j.1464-410X.2012.11600.x
- Referans4 EAU Guidelines. Edn. presented at the EAU Annual Congress Milan 2021. ISBN 978-94-92671-13-4.
- Referans5 Wessells H, Angermeier KW, Elliott S et al: Male urethral stricture: American Urological Association guideline. J Urol 2017;197:182.
- Referans6 Cotter KJ, Hahn AE, Voelzke BB, Myers JB, Smith TG, Elliott SP et al. Trends in Urethral Stricture Disease Etiology and Urethroplasty Technique From a Multi-institutional Surgical Outcomes Research Group. Urology 2019;130:167-174. doi:10.1016/j.urology.2019.01.046
- Referans7 Mundy AR, Andrich DE. Urethral strictures. BJU Int 2011;107(1):6-26. doi: 10.1111/j.1464-410X.2010.09800.x
- Referans8 Yildiz I, Gokalp F, Burak C, Karazindiyanoğlu S, Yildiz PO, Rencuzogullari İ et al. Relationship between the Severity of Coronary Artery Disease and Catheter-Associated Urethral Stricture in Patients with Acute Coronary Syndrome. J Tehran Heart Cent 2020;15(3):113-118. doi:10.18502/jthc.v15i3.4221
- Referans9 Palminteri E, Berdondini E, Verze P, Nunzio CD, Vitarelli A, Carmignani L et al. Contemporary urethral stricture characteristics in the developed world. Urology 2013;81(1):191-196. doi:10.1016/j.urology.2012.08.062
- Referans10 Kizilay F, Şimşir A, Özyurt C. Analysis of recurrent urethral strictures due to iatrogenic urethral trauma. Turk J Med Sci 2017;47(5):1543-1548. doi: 10.3906/sag-1701-36
- Referans11 Meddings J, Saint S, Fowler KE, Gaies E, Hickner A, Krein SL et al. The Ann Arbor Criteria for Appropriate Urinary Catheter Use in Hospitalized Medical Patients: Results Obtained by Using the RAND/UCLA Appropriateness Method. Ann Intern Med 2015;162(9 Suppl):S1-34. doi: 10.7326/M14-1304
- Referans12 Aoki T. Appropriate Use of Urinary Catheter in Acute Heart Failure Patients. Circ J 2018;82(6):1505-1506. doi:10.1253/circj.CJ-18-0447
- Referans13 Latini JM, McAninch JW, Brandes SB, Chung JY, Rosenstein D. SIU/ICUD Consultation On Urethral Strictures: Epidemiology, etiology, anatomy, and nomenclature of urethral stenoses, strictures, and pelvic fracture urethral disruption injuries. Urology 2014;83(3 Suppl):S1-7. doi:10.1016/j.urology.2013.09.009
- Referans14 Niels-Peter B, Riehmann M, Gasser TC. Absence of urethral strictures with suprapubic urinary drainage during extracorporeal circulation. J Urol 1993;150(2):337-339. doi:10.1016/s0022-5347(17)35478-2
- Referans15 Santucci RA, Joyce GF, Wise M. Male urethral stricture disease. J Urol 2007;177(5):1667-1674. doi:10.1016/j.juro.2007.01.041
- Referans16 Levy M, Gor RA, Vanni AJ, Stensland K, Erickson BA, Myers JB et al. The Impact of Age on Urethroplasty Success. Urology 2017;107:232-238. doi: 10.1016/j.urology.2017.03.066
- Referans17 Lumen N, Hoebeke P, Willemsen P, Troyer BD, Pieters R, Oosterlinck W. Etiology of urethral stricture disease in the 21st century. J Urol 2009;182(3):983-987. doi:10.1016/j.juro.2009.05.023
- Referans18 Andrade WS, Oliveira P, Laydner H, Ferreira EJP, Barreto-Filho JAS. Severity of erectile dysfunction is highly correlated with the syntax score in patients undergoing coronariography. Int Braz J Urol 2016;42(1):123-131. doi:10.1590/S1677-5538.IBJU.2015.0002
- Referans19 Hamur H, Duman H, Keskin E, Inci S, Kucuksu Z, Degirmenci H et al. The relation between erectile dysfunction and extent of coronary artery disease in the patients with stable coronary artery disease. Int J Clin Exp Med 2015;8(11):21295-21302; PMID: 26885069