The advent of selective internal urethrotomy under direct vision has enabled precision endoscopic surgery to be undertaken on a wide range of urethral strictures. A multi-centre survey of 197 cases involving 322 urethrotomy procedures from 5 urological departments in England is reported. The overall results after a follow-up of up to 4 years suggest that there is no indication for further procedures currently existing in 160 (81%) of those cases subjected to selective internal urethrotomy. The additional injection of triamcinalone acetate into the strictured area prior to urethrotomy is recommended in resistant cases. The procedure of selective internal urethrotomy is, in our opinion; the best primary method for the treatment of urethral stricture, and it is hoped this will reduce the indications for anastomotic or substitution urethroplasty.

Distigmine bromide (Ubretid) is a long-acting anticholinesterase which is thought to improve detrusor function, restoring normal voiding patterns which may have been disturbed by autonomic overactivity, particularly after surgery. Ninety-three patients entered a double-blind study of the effect of distigmine bromide versus placebo on voiding after prostatectomy. The results demonstrated that there was a trend towards improvement but no statistically significant increase in post-operative flow rates, in reduction in bladder volume, and in the incidence of re-catheterisation in the patients treated with distigmine bromide.