Dilation and other endoscopic approaches<unk>  dilation and other endoscopic approaches such as direct vision internal urethrotomy (DVIU), laser urethrotomy, and self intermittent dilation are the most commonly used treatments for<unk> . However, these approaches are associated with low success rates and may worsen the<unk> , making future attempts to surgically repair the<unk> more difficult. A Cochrane review found that performing intermittent self-dilatation may confer a reduced risk of recurrent<unk>  after endoscopic treatment, but the evidence is weak. Cell therapy approach through endoscopy Buccal mucosal tissue harvested under local anesthesia after culturing in the lab when applied through endoscopy after urethrotomy in a pilot study has yielded encouraging results. This method named as BEES-HAUS procedure needs to be validated through a larger multicentric study before becoming a routine application. Urethroplasty Urethroplasty refers to any open reconstruction of the<unk>  Success rates range from 85% to 95% and depend on a variety of clinical factors, such as<unk>  as the cause, length, location, and caliber. Urethroplasty can be performed safely on men of all ages. In the posterior<unk>  anastomotic urethroplasty (with or without preservation of bulbar arteries) is typically performed after removing scar tissue. In the bulbar<unk>  the most common types of urethroplasty are anastomotic (with or without preservation of corpus spongiosum and bulbar arteries) and substitution with buccal mucosa graft, full-thickness skin graft, or split thickness skin graft. These are nearly always done in a single setting (or stage). In the penile<unk>  anastomotic urethroplasties are rare because they can lead to chordee (penile curvature due to a shortened<unk> . Instead, most penile urethroplasties are substitution procedures utilizing buccal mucosa graft, full-thickness skin graft, or split-thickness skin graft. These can be done in one or more settings, depending on<unk>  location, severity, cause and patient or surgeon preference. The first reported cases using umbilical vein as<unk>  graft in<unk>  yielded good results 85%, Al-Naieb in 1985. the first 10 cases were reported in his PhD thesis submitted to Johannes Gutenberg University in Mainz Germany. After these successful results, 25 cases operated and published in Jordanian medical Journal in the nineties. with excellent results mainly posterior<unk>  published as Editorial in 2019:.EC Gynaecology 8.1 (21019): 01-12.<unk>  stent 3D Medical Animation still shot of<unk>  Stent A permanent<unk>  stent was approved for use in men with bulbar<unk> s in 1996, but was recently removed from the market. A temporary thermoexpandable<unk>  stent (Memotherm) is available in Europe but is not currently approved for use in the United States. Emergency treatment When in acute urinary retention, treatment of the<unk>  or diversion is an emergency. Options include: *<unk>  dilatation and catheter placement. This can be performed in the Emergency Department, a practitioner's office or an operating room. The advantage of this approach is that the<unk> may remain patent for a period of time after the dilation, though long-term success rates are low. * Insertion of a suprapubic catheter with catheter drainage system. This procedure is performed in an Operating Room, Emergency Department or practitioner's office. The advantage of this approach is that it does not disrupt the scar and interfere with future definitive surgery. Ongoing care Following urethroplasty, patients should be monitored for a minimum of 1 year, since the vast majority of recurrences occur within 1 year. Because of the high rate of recurrence following dilation and other endoscopic approaches, the provider must maintain a high index of suspicion for recurrence when the patient presents with obstructive voiding symptoms or urinary tract infection.
Urethral stricture
Urethral diverticulum
Urethral foreign body
Bulbar urethral necrosis
Ureteric stricture
Bladder outlet obstruction
Ureterovaginal fistula
Urethral syndrome