ABSTRACT
Objective: To observe the initial effectiveness of retrograde urethrotomy with a cold knife combined with the lucency via antegrade flexible cystoscopy in treatment of patients with obliterative urethral stricture. Methods: From September 2007 to April 2010, 8 patients with obliterative urethral stricture (0.8-2.0 cm in length) underwent antegrade-retrograde via flexible cystoscopy endoscopic urethrotomy with a cold knife: the initial effectiveness was observed. Results: All the 8 patients were successfully treated with antegrade-retrograde via flexible cystoscopy endoscopic urethrotomy with a cold knife. The operation time ranged 15-30 min, with a mean of 21 min. Urethral catheter (20-22F) was maintained for 4-6 weeks, and all the patients had passable urinary tract, with no urinary incompetence. The 8 patients were followed for 6-24 months (with a mean of 18 months). Three patients had no stricture recurrence and needed no further treatment. Four patients needed further intermittent urethral dilations(6-16 procedures, mean 12 procedures) to keep normal urination. One patient received a second endoscopic urethrotomy due to recurrent stricture 3 months after first treatment. Conclusion: The antegrade-retrograde urethrotomy via flexible cystoscopy with a cold knife can improve the successful rate of endoscopic surgery, with shorter operation time and satisfactory short-term outcome, but the long-term outcome needs to be further observed.