Outcome of urethral strictures treated by endoscopic urethrotomy and urethroplasty

Abstract

Introduction: We analyze the outcomes of patients with urethral stricture who underwent surgical treatment within the past 5 years. Methods: This is a retrospective study of male patients who underwent surgery for urethral stricture at our service from January 2008 to June 2012. We analyzed the comorbidities, type, length and location of the stricture and the surgical treatment outcome after endoscopic urethrotomy, urethroplasty or both. Results: In total, 45 patients with a mean age of 53.7 ± 16.7 years underwent surgical treatment for urethral stricture. Six months after surgery, 46.7% of the patients had a maximum urinary flow greater than 15 mL/s, whereas 87.3% of the patients exhibited no stricture by urethrography after the treatment. The success rate in the patients undergoing urethrotomy was 47.8% versus 86.4% in those undergoing urethroplasty (p = 0.01). Twenty percent of the patients in whom the initial urethrotomy had failed subsequently underwent urethroplasty, thereby increasing the treatment success. Conclusion: In most cases, the treatment of choice for urethral stricture should be urethroplasty. Previous treatment with urethrotomy does not appear to produce adverse effects that affect the outcome of a urethroplasty if urethrotomy failed, so urethrotomy may be indicated in patients with short strictures or in patients at high surgical risk.

High-pressure balloon dilation for male anterior urethral stricture: single-center experience

“…On the contrary, urethroplasty was traditionally considered a difficult surgical procedure and reserved for much more complex cases, although advanced with better longterm cure rates (Singh et al, 2011). However, it has been demonstrated that endoscopic surgery was superior to urethroplasty as long as the stricture did not exceed 2 cm in length, given its low morbidity and rapid convalescence (Wright et al, 2006;Hameed et al, 2011;Veeratterapillay and Pickard, 2012;Tinaut-Ranera et al, 2014).…”

The Comparable Results of Minimally Invasive Therapy versus Primary Anastomosis in the Management of Partial Posterior Urethral Stricture

“…In this study, we have proven that MIT procedure has quite similar results as compared to EPA procedure on many aspects such as QoL, IPSS score, urine residue, recurrence, erectile function as assessed by EHS score, Qmax value, and overall satisfaction measured by PPS [13]. By having those results, we showed that MIT procedure is not inferior as compared to EPA in the management of partial posterior urethral strictures in our institution.…”

“…By having those results, we showed that MIT procedure is not inferior as compared to EPA in the management of partial posterior urethral strictures in our institution. However, until recently, EPA is still deemed as a gold standard of treatment in the management of posterior urethral strictures in many studies [13], [14]. The results in this study do not attempt to against what has been decided as a gold standard in posterior urethral stricture management.…”

Comparative study between thulium laser and cold knife visual urethrotomy for treatment of short bulbomembranous urethral stricture

“…Moreover, stricture recurrence is commonplace when managing strictures through endoscopic approaches. [ 18 ] Several studies have compared the holmium laser and CKVU in managing short-segment urethral stricture. They have concluded that both techniques are safe and equally effective in treating short-segment urethral strictures in terms of outcome and complication rate.…”