Urethrotomy technique in urethral strictures: 6-year Results

Abstract

Our urethrotomy technique for strictures during the last 6 years is analyzed. Each stricture was widened radially over the entire circumference with incisions made close together. In this way a short or moderately long stricture can be eliminated completely in 1 session. For long and multiple strictures only the most distal portion was incised as far as possible. Then, after 2 to 3 weeks, control urethroscopy was done and the remaining stricture subsequently was incised without difficulty using the same technique. Urethrotomy was done with the patient under local anesthesia with mepivacaine because of the better field of view. Instillagel was not used. This technique does not require any followup treatment of the urethra. Since no indwelling catheter is needed foreign body urethritis, which can be the cause of stricture recurrences, is avoided. The postoperative course is shortened greatly. There is greater freedom from complications and the chances of healing are improved. The operation can be performed rapidly and the burden for the patient is slight. Secondary injuries are rare. Sessions can be repeated without complications. Potency is not endangered. This operation can be done on an ambulatory patient with any type of stricture. The late results in 202 patients with simple and complicated strictures who underwent this technique were evaluated. Most strictures were incised in 2 or 3 sessions, which gave the best results. A few complicated callous strictures that had been treated for years with bougienage were incised in 4 or 5 sessions. The over-all success rate of the late results is more than 80 per cent.

Thulium laser urethrotomy for urethral stricture: A preliminary report

“…As reported by Djulepa and Potempa 14 most of the urethral strictures showed annular stricture. More attention should be paid when incising at 11 O'clock–1 O'clock in stricture of the posterior urethra to avoid injury to surrounding important tissue.…”

Minimally invasive techniques of urethral stricture treatment and their use in patients of pediatric age (literature review)

“…Более длительная катетеризация может вызвать воспаление и ухудшение результата лечения. Однако есть исследователи, которые оставляют катетер на 6 нед [44], 10-14 дней [25], 3 дня [30], 24 ч, а некоторые и вовсе не используют катетеризацию [45,46].…”

Internal urethrotomy

“…Multiple Inzisionen an unterschiedlichen Positionen, der Einsatz des Lasers sowie die Injektion von Kortikosteroiden im Bereich der Läsionen wurden bereits vorgeschlagen, scheinen die endgültigen Resultate jedoch nicht zu verbessern [4,14,16].…”