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Ketabchi, A. (2017). Evaluation of Combined Electro Cutter with Cold Knife in the Intractable Anterior Urethral Stricture Urethrotomy. Journal of Kerman University of Medical Sciences, 24(6), 487-497.
Aliassghar Ketabchi. "Evaluation of Combined Electro Cutter with Cold Knife in the Intractable Anterior Urethral Stricture Urethrotomy". Journal of Kerman University of Medical Sciences, 24, 6, 2017, 487-497.
Ketabchi, A. (2017). 'Evaluation of Combined Electro Cutter with Cold Knife in the Intractable Anterior Urethral Stricture Urethrotomy', Journal of Kerman University of Medical Sciences, 24(6), pp. 487-497.
Ketabchi, A. Evaluation of Combined Electro Cutter with Cold Knife in the Intractable Anterior Urethral Stricture Urethrotomy. Journal of Kerman University of Medical Sciences, 2017; 24(6): 487-497.

Evaluation of Combined Electro Cutter with Cold Knife in the Intractable Anterior Urethral Stricture Urethrotomy

Article 5, Volume 24, Issue 6, November and December 2017, Page 487-497  XML PDF (2.66 MB)
Document Type: Original Article
Author
Aliassghar Ketabchi email
Professor of Urology, Physiology Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, Iran
Abstract
Background: Sachse cold knife is conventionally used for optical internal urethrotomy to manage urethral strictures. In this procedure, the complications and recurrence rates are relatively high. We suggest combined electro cutter and cold knife as a success alternative in the management of intractable anterior urethral strictures.
Methods: In this prospective study, 87 male patients aged ≥18 years, with diagnosed intractable urethral stricture (≥2 times recurrence) who were admitted for internal optical urethrotomy during May 2010 to Jun 2013, were included. The patients were randomized into two groups: group A (electro cutter - cold knife group, n= 45) and group B (cold knife group, n= 42). In group A, internal urethrotomy was done with electro cutter - cold knife, and in group B, Sachse cold knife was used. Patients were followed up for 6 months after surgery in Outpatient Department on 15, 30 and 180 post-operative days.
Results: The success rates in group A and B were 46.6% (21 out of 45 patients), and 23.80% (10 out of 42 patients), respectively (P<0.05). The complications were seen in 11% of group A and 64% of group B. At 180 days (6-month interval), the difference between mean of PFR for electro cutter -cold knife group and cold knife group was statistically significant (P<0.01).
Conclusion: Combined electro cutter with cold knife urethrotomy modality is effective than conventional cold knife urethrotome in providing immediate relief in recurrent urethral strictures and has lesser complications in patients with intractable and recurrent urethral strictures.
Keywords
Urethrotomy; Intractable; Urethral stricture; Electro cutter
References
  1. Das S. Urology in ancient India. Indian J Urol 2007; 23(1): 2–5.
  2. Zonana FE. Uretrotomía interna, experiencia en el hospital central militar. Rev Mex Urol 1982;42:235-39.
  3. Jiménez A. Estenosis de uretra masculina. Rev Mex Urol 1983;43:1.
  4. Santucci RA, Joyce GF, Wise M. Male urethral stricture disease. J Urol 2007;177(5):1667-74.
  5. Lipsky H, Hubmer G. Direct vision urethrotomy in the management of urethral strictures. Br J Urol 1977;49(7):725-8.
  6. Smith PJ, Kaisary AV, Ball AJ. Late results of optical urethrotomy. J R Soc Med 1984; 77(2): 105–7.
  7. Albers P, Fichtner J, Brühl P, Müller SC. Long-term results of internal urethrotomy. J Urol 1996;156(5):1611-4.
  8. Chhetri RK, Shrestha GK, Joshi HN, Shrestha RK. Management of urethral strictures and their outcome. Nepal Med Coll J 2009;11(1):5-8.
  9.   Slawomir A. Dutkiewicz • Mariusz Wroblewski. Comparison of treatment results between holmium laser endourethrotomy and optical internal urethrotomy for urethral stricture. Int Urol Nephrol (2012) 44:717–724. DOI 10.1007/s11255-011-0094-8.
  10. Kumar S, Kapoor A, Ganesamoni R, Nanjappa B, Sharma V, Mete UK. Efficacy of Holmium Laser Urethrotomy in Combination with Intralesional Triamcinolone in the Treatment of Anterior Urethral Stricture. Korean Journal of Urology. 2012;53(9):614-618. doi:23060998Martínez-Piñeiro L, Djakovic N, Plas E, Mor Y, Santucci RA, Serafetinidis E, et al. EAU Guidelines on Urethral Trauma. Eur Urol 2010;57(5):791-803.
  11. Saavedra-Briones Dorian V M-CCE, Sánchez-Turati Gustavo, Cantellano-Orozco Mauricio,and etal. Urethral stricture recurrence following internal urethrotomy. Rev Mex Urol 2009;69(4):153-8.
  12. Al Taweel W, Seyam R. Visual Internal Urethrotomy for Adult Male Urethral Stricture Has Poor Long-Term Results. Advances in Urology. 2015;2015:656459. doi:10.1155/2015/656459.Montorsi F, Naspro R, Salonia A, Suardi N, Briganti A, Zanoni M, et al. Holmium laser enucleation versus transurethral resection of the prostate: results from a 2-center, prospective, randomized trial in patients with obstructive benign prostatic hyperplasia. J Urol 2004;172(5 Pt 1):1926-9.
  13. Matsuoka K, Inoue M, Iida S, Tomiyasu K, Noda S. Endoscopic antegrade laser incision in the treatment of urethral stricture. Urology 2002;60(6):968-72.
  14. Smith P, Dunn M, Dounis A. Sachse optical urethrotome in management of urethral stricture in the male: preliminary communication. J R Soc Med 1978;71(8):596-9.
  15. Netto NR, Lemos GC, Figueiredo JA. A comparative study of electrosurgical vs. cold urethrotomy in the treatment of urethral strictures. Int Urol Nephrol 1979;11(4):311-5.
  16. Sertcelik N, Sagnak L, Imamoglu A, Temel M, Tuygun C. The use of self-expanding metallic urethral stents in the treatment of recurrent bulbar urethral strictures: long-term results. BJU Int 2000;86(6):686-9.
  17. Jain SK, Kaza RC, Singh BK. Evaluation of holmium laser versus cold knife in optical internal urethrotomy for the management of short segment urethral stricture. Urol Ann 2014;6(4):328-33.
  18. Kumar S, Garg N, Singh SK, Mandal AK. Efficacy of Optical Internal Urethrotomy and Intralesional Injection of Vatsala-Santosh PGI Tri-Inject (Triamcinolone, Mitomycin C, and Hyaluronidase) in the Treatment of Anterior Urethral Stricture. Adv Urol 2014; 2014: 192710.
  19. Stamatiou K, Papadatou A, Moschouris H, Kornezos I, Pavlis A, Christopoulos G. A Simple Technique to Facilitate Treatment of Urethral Strictures with Optical Internal Urethrotomy. Case Rep Urol 2014; 2014: 137605.
  20. Dutkiewicz SA, Wroblewski M. Comparison of treatment results between holmium laser endourethrotomy and optical internal urethrotomy for urethral stricture. Int Urol Nephrol 2012;44(3):717-24.
  21. Atak M, Tokgöz H, Akduman B, Erol B, Dönmez I, Hancı V, et al. Low-power holmium:YAG laser urethrotomy for urethral stricture disease: comparison of outcomes with the cold-knife technique. Kaohsiung J Med Sci 2011;27(11):503-7.
  22. Kamal BA. The use of the diode laser for treating urethral strictures. BJU Int 2001;87(9):831-3.
  23. Ozcan L, Polat EC, Otunctemur A, Onen E, Cebeci OO, Memik O, et al. Internal urethrotomy versus plasmakinetic energy for surgical treatment of urethral stricture. Arch Ital Urol Androl 2015;87(2):161-4.
  24. Hussain M, Lal M, Askari SH, Hashmi A, Rizvi SA. Holmium laser urethrotomy for treatment of traumatic stricture urethra: a review of 78 patients. J Pak Med Assoc 2010;60(10):829-32.
  25. Dubey D. The current role of direct vision internal urethrotomy and self-catheterization for anterior urethral strictures. Indian J Urol 2011;27(3):392-6.
  26. Zehri AA, Ather MH, Afshan Q. Predictors of recurrence of urethral stricture disease following optical urethrotomy. Int J Surg 2009;7(4):361-4.
  27. Santucci R, Eisenberg L. Urethrotomy has a much lower success rate than previously reported. J Urol 2010;183(5):1859-62.
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