Urinary Catheterization for Urethral Stricture, Whom and How Long?

Abstract

Objective: Narrowing of the urethral lumen due to fibrosis, which occurs in the urethral mucosa and the surrounding tissue, is defined as urethral stricture. Even though the most common reason for urethral stricture is idiopathic, trauma and iatrogenic applications can also cause urethral stricture. In this study, we analyzed the association between recurrent stricture and urinary catheterization duration in patients who underwent direct vision internal urethrotomy for urethral stricture.Methods: In our clinic, in 2014, we analyzed 157 patients who underwent direct vision internal urethrotomy with a cold knife for urethral stricture. All patients were divided into the following three groups as 3 days, 5 days, and 7 days after the operation in terms of urinary catheterization duration. To analyze the association between recurrent and postoperative Qmax values, Chi-square test and one-way analysis of variance (ANOVA) were performed.Results: The mean age of 157 patients was 63.51±13.86 years. The mean preoperative Qmax, stricture length, and postoperative Qmax values of all patients were 6.07±2.70 mL/s, 2.61±2.19 cm, and 10.9±4.1 mL/s, respectively. Additionally, 49 (31.2%) patients had recurrent stricture and 108 (68.8%) patient had no recurrence. In total, 17 (36%) patients in the 3-day postoperative urinary catheterization group, 12 (22%) in the 5-day group, and 20 (35%) in the 7-day group had recurrent stricture. Statistical analyses revealed no statistical significance between groups in terms of recurrent stricture and postoperative Qmax values.Conclusion: Currently, the recommended gold standard treatment for urethral stricture is direct vision internal urethrotomy. In the literature, many studies have compared surgical techniques and results. In our study, we found no statistical significance between urinary catheterization duration (3, 5, or 7 days postoperatively) in patients who underwent direct vision cold knife internal urethrotomy. The duration of postoperative urinary catheterization should not be extended; we recommend that remove it as soon as possible. After the operation, we believe that urinary catheterization must remove reasonable period of time, so patient comfort can be increased and urinary catheterization for recurrent strictures that develop due to remaining for a long time, could have been avoided. (JAREM 2015; 5: 121-4)