The Impact of Optical Urethrotomy on the Management of Urethral Strictures

Abstract

The introduction of optical urethrotomy by Sachse has reduced the need for urethroplasty: 261 urethroplasties were performed between 1964 and 1983, of which 87 were performed in one stage on patients who would today have undergone urethrotomy as the procedure of first choice. The results in this group are compared with those in 151 patients treated between 1978 and 1983 by 265 internal optical urethrotomies. At 5 years 50% of those treated by urethrotomy needed no further treatment, compared with 83% of those treated by urethroplasty. Nevertheless, the ease and safety of urethrotomy makes it the procedure of first choice, and urethoroplasty should be reserved either for cases where urethrotomy is unsuitable or where it has been tried on several occasions without success.

Is Direct Vision Internal Urethrotomy a Viable Option for Treating Urethral Strictures in Patients with Morbidities: Our Experience

“…The idiopathic etiology of stricture in our study was idiopathic in 39.13% followed by traumatic injuries in 26% cases. In contrast to our study Chelton et al [10] reported 11.5% traumatic stricture. The high incidence of traumatic stricture in our study was due to road traffic accidents & war injuries.…”

End‐to‐end urethroplasty: long‐term results

“…In 1983, Chilton et al [11] treated all but 5% of 261 patients endoscopically for urethral stenosis, although even then there were already reports of numerous series in which cure rates were 80-95% with end-to-end anastomosis [12]. In 1993 Mundy [13] noted that most urethral strictures were still treated by urethrotomy and/or dilatation, and asserted that urethroplasty had a minor role, being indicated only in patients with particularly complex strictures, or in whom previous treatments had failed.…”

Management of anterior urethral stricture

“…Multiple strictures were found in 7% of cases. Various other studies have also reported bulbar urethra being the commonest site of urethral stricture [10,11]. In the present study 80% of the cases had short strictures i.e., stricture length was less than 2 cms.…”