Urethral strictures or stenoses are treated endoscopically or with urethroplasty. Endoscopic management is performed by either urethral dilation or direct vision internal urethrotomy (DVIU). There are a multitude of different urethroplasty techniques that can be generally divided into tissue transfer involved procedures and non -tissue transfer involved procedures. Anastomotic urethroplasty does not involve tissue transfer and can be performed in both a transecting and non-transecting manner. Excision and primary anastomosis (EPA) urethroplasty involves transection and removal of the narrowed segment of urethra and corresponding spongiofibrosis with anastomosis of the two healthy ends of the urethra. Non-transecting anastomotic urethroplasty preserves the corpus spongiosum, thus allowing the strictured urethra to be excised and reanastomosed, or incised longitudinally through the narrowed segment of the urethra and closed in a Heineke-Mikulicz fashion.
M genitalium , not routinely tested by polymerase chain reaction (PCR) in many locations, may cause up to 10-30% of NGU cases [ 1 , 2 , 13 ] and, like chlamydia, may be associated with human immunodeficiency virus (HIV), human papilloma virus (HPV), and herpes simplex transmission and infection. M genitalium has been associated with treatment failure to presently recommended single-dose therapy, owing to macrolide resistance, [ 14 , 15 , 3 , 16 , 13 , 17 , 4 ] and has potential for quinolone resistance as well. [ 16 , 4 , 18 , 15 ] Couldwell et al describe rates of resistance of 15% for quinolones and 43% for macrolides among 143 M genitalium specimens in Australia in 2013. [ 16 ]
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