OBJECTIVES: To describe the Heineke-Mikulicz principle in urethral surgery and to evaluate preliminary surgical and functional outcomes of this technique. METHODS: Ten patients (of a cohort of more than 400 patients treated with urethroplasty during a 7-year period) with a urethral stricture were treated using the Heineke-Mikulicz principle: a ventral longitudinal stricturotomy was performed with transversal closure of the urethra. Only patients with a short (<1 cm), not too narrow or fibrotic stricture at the bulbar urethra or fossa navicularis were considered as appropriate candidates. At closure of the study, all patients were sent a questionnaire about the functional outcome of the procedures. This included questions about postoperative shortening, chordee, postvoid dribbling, ejaculatory disturbances, erectile dysfunction, and penile sensitivity. RESULTS: Mean follow-up was 46.6 months (range: 15-79 months). There were no immediate or early postoperative complications. Nine of 10 patients (90%) were successfully treated. On the questionnaire, 1 patient reported mild postoperative chordee and shortening, and 1 patient complained of postvoid dribbling. None of the sexually active patients reported ejaculatory disturbances, erectile dysfunction, or diminished penile sensitivity. CONCLUSIONS: The preliminary surgical and functional results with the Heineke-Mikulicz principle are promising. Larger cohorts of patients are needed for further evaluation.
OBJECTIVES: To describe the Heineke-Mikulicz principle in urethral surgery and to evaluate preliminary surgical and functional outcomes of this technique. METHODS: Ten patients (of a cohort of more than 400 patients treated with urethroplasty during a 7-year period) with a urethral stricture were treated using the Heineke-Mikulicz principle: a ventral longitudinal stricturotomy was performed with transversal closure of the urethra. Only patients with a short (<1 cm), not too narrow or fibrotic stricture at the bulbar urethra or fossa navicularis were considered as appropriate candidates. At closure of the study, all patients were sent a questionnaire about the functional outcome of the procedures. This included questions about postoperative shortening, chordee, postvoid dribbling, ejaculatory disturbances, erectile dysfunction, and penile sensitivity. RESULTS: Mean follow-up was 46.6 months (range: 15-79 months). There were no immediate or early postoperative complications. Nine of 10 patients (90%) were successfully treated. On the questionnaire, 1 patient reported mild postoperative chordee and shortening, and 1 patient complained of postvoid dribbling. None of the sexually active patients reported ejaculatory disturbances, erectile dysfunction, or diminished penile sensitivity. CONCLUSIONS: The preliminary surgical and functional results with the Heineke-Mikulicz principle are promising. Larger cohorts of patients are needed for further evaluation.
Authors: Sarah D Blaschko; Melissa T Sanford; Nadya M Cinman; Jack W McAninch; Benjamin N Breyer Journal: BJU Int Date: 2013-03-04 Impact factor: 5.588
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