Outcome of optical internal urethrotomy in urethral stricture: a prospective study

This study was conducted to assess the role of optical internal urethrotomy in patients with urethral stricture. This study was conducted at Khyber Teaching Hospital Peshawar and Khattak Medical Centre Peshawar from March 2003 August 2003. Male patients were selected from the patients presenting with history of urethral stricture regardless of age and etiology. Patients with neurogenic bladder; enlarged prostate, bladder stone or meatal stricture were excluded. All patients were investigated with standardized protocol. Optical internal urethrotomy was performed in all patients and they were followed at monthly interval. The success of procedure was evaluated by grading the patient response as excellent, good, acceptable and poor. Out of 30 patients, 11[36.66%] were between 20 and 30 years of age. The most common cause was trauma 21[70%].The most common site was bulbous urethra in 22 [73.33%] cases followed by membranous urethra in 4[13.33%] cases. In patients with stricture of less than 1 cm, 21/25[84%] showed excellent response while in stricture of more than 1 cm, 1/5[20%] showed excellent response. Excellent results were seen in patients with stricture in 18/22 [81.81%] cases of bulbous urethra. Nine [30%] cases showed minor post operative complications with no major complications. No recurrence was reported in 3 months follow up. Internal optical urethrotomy is a safe first line treatment in urethral stricture independent of the cause. It has low morbidity for the working class people

Experience with cold knife optical internal urethrotomy

To evaluate the outcome and efficacy of cold knife optical internal urethrotomy. Design: A retrospective analysis of 120 cases. Place and Duration of Study: The study was carried out over a period of three years [May 1996 - June 1999] in the Department of Surgery, Khyber Teaching Hospital, Peshawar; and Medicare Hospital [Private], Peshawar. Subjects and One hundred and twenty male patients with urethral strictures were treated with cold knife optical urethrotomy over a period of three years. An analysis was carried out of the short-term results of optical internal urethrotomy to determine the outcome and efficacy of the procedure. The age range was 14-80 years, the mean age being 35 years. The follow-up period on treated patients ranged from three months to thirty-three months. The results awed that early morbidity was 16.6% with no mortality. The recurrence rate was 7% [8 out of 120]. The results are consistent with other studies and confirm this as the preferred initial procedure in urethral strictures of bulbar, membranous and proximal penile urethra. Optical internal urethrotomy is the preferred initial management of urethral stricture. Urethroplasty should be considered in failed optical urethrotomy and recurrent stricture disease

outcome of transurethral resection of the prostate

To evaluate the effectiveness of transurethral resection of prostate. Design: Retrospective study. Place and Duration of Study: The study was carried out at the Department of Surgery, Khyber Teaching Hospital, Peshawar and Medicare Hospital [private], Peshawar, over a period of three years [May 1996-June 1999]. Subjects and The pre and postoperative data of 520 patients of benign prostatic hyperplasia and carcinoma of the prostate, was studied to establish the range of efficacy of the transurethral resection procedure. The age range of the patients was between 45-100 years. 520 cases in all were studied, of which, 470 cases were suffering from benign prostatic hyperplasia, and 50 cases from carcinoma of prostate. Twenty more cases of cancer were identified coincidentally on histology of the specimens. Of these, 450 cases [86.6%] presented with urinary retention and 25 cases [5%] with urinary symptoms only. The procedure was done under spinal or epidural anesthesia with a morbidity of about 19%. Three patients died of unrelated causes 3 - 4 weeks after surgery. It is concluded that transurethral resection of the prostate is a considerably safe procedure, and can effectively replace open prostatectomy in majority of cases with an acceptable morbidity and low mortality rates