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KOMPLET ÜRETRAL DARLIKLARININ ENDOSKOPİK TEDAVİSİ ‘CUT TO THE LIGHT’ Endoscopic Treatment of Complete Urethral Strictures ‘Cut to the light’

Year 2017, Volume: 7 Issue: 4, 25 - 28, 13.12.2017

Abstract

ÖZET

Amaç: Günümüzde komplet üretral darlıklarının tedavisinde birden fazla tedavi seçeneği mevcuttur. Açık

cerrahi yöntemlerinin yanı sıra düşük morbidite, uygulanabilme kolaylığı nedeniyle endoskopik tedaviler

de uygulanmaktadır. Bu çalışmada komplet üretral darlık nedeniyle yapılan endoskopik tedavi ‘cut to the

light’ yönteminin sonuçlarının değerlendirilmesi amaçlanmıştır.

Gereç ve Yöntem: Hastane kayıtları incelenerek, iatrojenik ve pelvik travma öyküsü olan tüm komplet

üretral darlık nedeniyle tedavi olan hastaların dataları retrospektif olarak kayıt altına alındı.Bu grup hastalardan

‘cut to the light’ dışında tedavi uygulananlar çalışmadan çıkarıldı. Tüm hastalarda işlem öncesi

sistostomi kateteri mevcuttu. Sistostomi kateterinden mesane serum fizyolojik ile doldurularak perkütan

giriş yapıldı, dilatasyonu takiben mesaneye fleksibl sistoskop ile girilirken eş zamanlı olarak üretradan

üretrotomla girildi. Fleksibl sistoskopun komplet darlığın arkasında görülen ışığı rehber olacak şekilde

üretrotomun soğuk bıçağı ile komplet darlık kesildi. Takip süresince rekürren darlıklar kayıt altına alındı.

Bulgular: Toplam on hastaya ‘cut to the light’ işlemi uygulandı. Ortalama yaş 51 (17-73) idi. Etiyolojide

hastaların %50’si iatrojenik, %50’si travmatik nedenliydi. Hastaların altısında charlson komorbidite skoru

3 ve üzeriydi. Ortalama takip süresi 405 gündü. Nüks oranı %50 idi. Tüm nüksler internal üretrotomi ile

tedavi edildi.Hastaların dördü takipte komorbiditeye bağlı exitus oldu.

Sonuç: Uygulama kolaylığı, düşük morbidite oranları ve hastanın hastanede kalış süresinin oldukça kısa

olması nedeniyle komplet üretral darlıklarının endoskopik tedavisi üretroplasti öncesi bir basamak olabilir.

Anahtar Sözcu¨kler: Üretral darlık; Cut to the light; Endoskopi; Fleksibl


ABSTRACT

Objectives: Today, in the treatment of complete urethral strictures multiple treatment options

are available. As well as open surgery, endoscopic treatments are applied, because of the ease of

implementation and lower morbidity. In this study, we aimed to evaluate the results of endoscopic

therapy ‘cut to the light’ method due to complete urethral strictures

Material and Methods: All data of patients treated with complete urethral strictures due to pelvic trauma

or iatrogenic were recorded retrospectively by examining hospital records. From this group of patients,

those treated with the exception of ‘cut to the light’ were excluded from the study. All patients had

cystotomy catheter before the procedure. Percutaneous access was done after filling the bladder with

saline from the cystostomy catheter. Flexible cystoscopy was done after dilatation while urethrotome

was inserted through the urethra simultaneously. Under the guidance of flexible cystoscopy light behind

the complete stricture, it was cut by urethrotome with cold knife. Recurrent stenoses were recorded

during follow-up.

Results: A total of ten patients ‘cut to the light’ procedure was performed. The mean age was 51

(17-73). Etiology was iatrogenic in 50% of patients while traumatic in 50%. Six patients had Charlson

comorbidity score of 3 or higher. Mean follow-up time was 405 days. The recurrence rate was 50%. All

recurrences were treated with internal urethrotomy. Four patients at follow-up were exitus depending

on comorbidities

Conclusion: Because of the ease of implementation, lower morbidity, and relatively short duration in

hospital Endoscopic treatment of complete urethral stricture may be a step ahead than urethroplasty.

Keywords: Urethral stricture; Cut to the light; Endoscopy; Flexible

References

  • 1. Stewart S, Hart CL, Hole DJ, McMurray JJ. Population prevalence, incidence, andpredictors of atrial fibrillation in the Renfrew/Paisley study. Heart 2001;86:516–21. 2. Zýpes DP. Specific arrhythmias: Diagnosis and treatment. In: Braunwald E, ed. Heart Disease. A Ttextbook of Cardiovascular medicine. Philadelphia: WB Saunders Company, 1992:682. 3. Hogue CW Jr, Hyder ML. Atrial fibrillation after cardiac operation: Risks, mechanism, and treatment. Ann Thorac Surg 2000;69:300-6. 4. Habibollahi P, Jam SH, Vahdati SS, Baghi HM, Amiri H. Amiodaron in atrial fibrillation: post coronary artery bypass graft.World J Emerg Med. 2016;7(4):250-254. 5. Lewicki L, Siebert J, Rogowski J.Atrial fibrillation following offpump versus on-pump coronary artery bypass grafting: Incidence and risk factors.Cardiol J. 2016 Sep 26. doi: 10.5603/CJ.a2016.0066. 6. Zaman A, Archbold A, Helft G, et al. Atrial fibrillation after coronary artery bypass surgery. Circulation 2000; 101: 1403-8. 7. Aranki F, Shaw D, Adams D, et al. Predictors of atrial fibrillation after coronary artery surgery. Chin Med J (Engl) 2002; 115(2): 232-4. 8. Place D, Peragallo A, Carroll R, et al. Postoperative atrial fibrillation: A comparison of off-pump coronary artery bypass surgery and conventional coronary artery bypass graft surgery. J Cardiothorac Vasc Anesth 2002;16(2): 144-8. 9. Luo W, Huaibin W, Wenjun Z, Jie T, Xiaokang O, et al.Predictors of Postoperative Atrial Fibrillation after Isolated On-Pump Coronary Artery Bypass Grafting in Patients ≥60 Years Old.Heart Surg Forum. 2017 Feb 28;20(1):E038-E042. doi: 10.1532/hsf.1583. 10. Hakala T, Hedman A. Predicting the risk of atrial fibrillation after coronary artery bypass surgery. Scand Cardiovasc J 2003; 37: 309-15.
Year 2017, Volume: 7 Issue: 4, 25 - 28, 13.12.2017

Abstract

References

  • 1. Stewart S, Hart CL, Hole DJ, McMurray JJ. Population prevalence, incidence, andpredictors of atrial fibrillation in the Renfrew/Paisley study. Heart 2001;86:516–21. 2. Zýpes DP. Specific arrhythmias: Diagnosis and treatment. In: Braunwald E, ed. Heart Disease. A Ttextbook of Cardiovascular medicine. Philadelphia: WB Saunders Company, 1992:682. 3. Hogue CW Jr, Hyder ML. Atrial fibrillation after cardiac operation: Risks, mechanism, and treatment. Ann Thorac Surg 2000;69:300-6. 4. Habibollahi P, Jam SH, Vahdati SS, Baghi HM, Amiri H. Amiodaron in atrial fibrillation: post coronary artery bypass graft.World J Emerg Med. 2016;7(4):250-254. 5. Lewicki L, Siebert J, Rogowski J.Atrial fibrillation following offpump versus on-pump coronary artery bypass grafting: Incidence and risk factors.Cardiol J. 2016 Sep 26. doi: 10.5603/CJ.a2016.0066. 6. Zaman A, Archbold A, Helft G, et al. Atrial fibrillation after coronary artery bypass surgery. Circulation 2000; 101: 1403-8. 7. Aranki F, Shaw D, Adams D, et al. Predictors of atrial fibrillation after coronary artery surgery. Chin Med J (Engl) 2002; 115(2): 232-4. 8. Place D, Peragallo A, Carroll R, et al. Postoperative atrial fibrillation: A comparison of off-pump coronary artery bypass surgery and conventional coronary artery bypass graft surgery. J Cardiothorac Vasc Anesth 2002;16(2): 144-8. 9. Luo W, Huaibin W, Wenjun Z, Jie T, Xiaokang O, et al.Predictors of Postoperative Atrial Fibrillation after Isolated On-Pump Coronary Artery Bypass Grafting in Patients ≥60 Years Old.Heart Surg Forum. 2017 Feb 28;20(1):E038-E042. doi: 10.1532/hsf.1583. 10. Hakala T, Hedman A. Predicting the risk of atrial fibrillation after coronary artery bypass surgery. Scand Cardiovasc J 2003; 37: 309-15.
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Details

Journal Section Original Research
Authors

Barbaros Başeskioğlu

Burak Elmaağaç This is me

Aydın Yenilmez This is me

İyimser Üre This is me

Publication Date December 13, 2017
Published in Issue Year 2017 Volume: 7 Issue: 4

Cite

APA Başeskioğlu, B., Elmaağaç, B., Yenilmez, A., Üre, İ. (2017). KOMPLET ÜRETRAL DARLIKLARININ ENDOSKOPİK TEDAVİSİ ‘CUT TO THE LIGHT’ Endoscopic Treatment of Complete Urethral Strictures ‘Cut to the light’. Bozok Tıp Dergisi, 7(4), 25-28.
AMA Başeskioğlu B, Elmaağaç B, Yenilmez A, Üre İ. KOMPLET ÜRETRAL DARLIKLARININ ENDOSKOPİK TEDAVİSİ ‘CUT TO THE LIGHT’ Endoscopic Treatment of Complete Urethral Strictures ‘Cut to the light’. Bozok Tıp Dergisi. December 2017;7(4):25-28.
Chicago Başeskioğlu, Barbaros, Burak Elmaağaç, Aydın Yenilmez, and İyimser Üre. “KOMPLET ÜRETRAL DARLIKLARININ ENDOSKOPİK TEDAVİSİ ‘CUT TO THE LIGHT’ Endoscopic Treatment of Complete Urethral Strictures ‘Cut to the light’”. Bozok Tıp Dergisi 7, no. 4 (December 2017): 25-28.
EndNote Başeskioğlu B, Elmaağaç B, Yenilmez A, Üre İ (December 1, 2017) KOMPLET ÜRETRAL DARLIKLARININ ENDOSKOPİK TEDAVİSİ ‘CUT TO THE LIGHT’ Endoscopic Treatment of Complete Urethral Strictures ‘Cut to the light’. Bozok Tıp Dergisi 7 4 25–28.
IEEE B. Başeskioğlu, B. Elmaağaç, A. Yenilmez, and İ. Üre, “KOMPLET ÜRETRAL DARLIKLARININ ENDOSKOPİK TEDAVİSİ ‘CUT TO THE LIGHT’ Endoscopic Treatment of Complete Urethral Strictures ‘Cut to the light’”, Bozok Tıp Dergisi, vol. 7, no. 4, pp. 25–28, 2017.
ISNAD Başeskioğlu, Barbaros et al. “KOMPLET ÜRETRAL DARLIKLARININ ENDOSKOPİK TEDAVİSİ ‘CUT TO THE LIGHT’ Endoscopic Treatment of Complete Urethral Strictures ‘Cut to the light’”. Bozok Tıp Dergisi 7/4 (December 2017), 25-28.
JAMA Başeskioğlu B, Elmaağaç B, Yenilmez A, Üre İ. KOMPLET ÜRETRAL DARLIKLARININ ENDOSKOPİK TEDAVİSİ ‘CUT TO THE LIGHT’ Endoscopic Treatment of Complete Urethral Strictures ‘Cut to the light’. Bozok Tıp Dergisi. 2017;7:25–28.
MLA Başeskioğlu, Barbaros et al. “KOMPLET ÜRETRAL DARLIKLARININ ENDOSKOPİK TEDAVİSİ ‘CUT TO THE LIGHT’ Endoscopic Treatment of Complete Urethral Strictures ‘Cut to the light’”. Bozok Tıp Dergisi, vol. 7, no. 4, 2017, pp. 25-28.
Vancouver Başeskioğlu B, Elmaağaç B, Yenilmez A, Üre İ. KOMPLET ÜRETRAL DARLIKLARININ ENDOSKOPİK TEDAVİSİ ‘CUT TO THE LIGHT’ Endoscopic Treatment of Complete Urethral Strictures ‘Cut to the light’. Bozok Tıp Dergisi. 2017;7(4):25-8.
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