Clinical Assessment of Visual Internal Urethrotomy as Primary Treatment of Urethral Stricture / 대한비뇨기과학회지

PURPOSE: We describe clinical assessment of visual internal urethrotomy (VIU) as primary treatment modality in 69 men who presented with complete or partial obstructed urethral stricture. MATERIALS AND METHODS: The 63 patients with partial obstructed urethral stricture were treated by typical VIU. The 6 men with complete obstructed urethral stricture were treated by VIU using sound passed through previously placed suprapubic tract as guide. RESULTS: The procedure was completed successfully in 57 of the 63 men with partial obstructed (90.5%) and 3 of 6 patients with complete obstructed urethral stricture (50%). CONCLUSIONS: VIU is a safe and effective as primary treatment plan when urethral stricture is partial obstructed and the impassable urethral segment is shorter than 1.0cm.

A Comparative Study of Visual Internal Urethrotomy and Perineal Urethroplasty in the Treatment of Posttraumatic Urethral Strictures / 대한비뇨기과학회지

The outcomes of treatment of 31 patients who were managed by single visual internal urethrotomy were compared with those of 25 patients managed by perineal urethroplasty to asses whether the replacement of almost urethroplasty by the simpler urethrotomy was justified. The overall successful results were achieved in 51.6% of visual internal urethrotomy and 76%, of urethroplasty. Patients with anterior urethral strictures more than 1 cm long or completely obliterated strictures had higher failure rates in the visual internal urethrotomy than urethroplasty (p<0.05). The morbidity rates were 9.6% in the visual internal urethrotomy and 24% in the urethroplasty. We recommend that visual internal urethrotomy be reserved for patients with urethral strictures 1 cm or less in length and posterior urethral stricture which is supposed to have a high recurrence rate since the procedure is simple and it does not compromise asecondary urethroplasty.

Two Cases of Congenital Urethral Stenosis with Recurrent Urinary Tract Infection / 대한비뇨기과학회지

Congenital urethral stricture are uncommon in boys and occurs at the junction of the endodermal primary urethra and ectodermal secondary urethra. This structure is thought to be related embryonically to failure of complete dissolution of urogenital membrane at the junction of the urogenital sinus and genital fold. Endoscopically, this lesion is recognized as a ring-form stenosis just distal to the external urethral sphincter. Congenital urethral stricture is an important cause of recurrent urinary tract infections, enuresis, failure in thrive or hematuria in pediatric urological practice. The most effective treatment of this lesion is optic internal urethrotomy under direct vision. We report two cases of 6 and 12-year-old boys hospitalized with complaints of high fever, dysuria, urgency and frequency. Six-year-old boy has grade III VUR and 12-year-old boy has grade IV VUR with Hutch diverticulum. We managed with visual internal urethrotomy only in 6-year-old boy but visual internal urethrotomy and bilateral ureteroneocystostomy in 12-year-old boy.

Antegrade light guiding visual internal urethrotomy in complete urethral stricture / 대한비뇨기과학회지

Visual internal urethrotomy (VIU) is a valuable initial management methods of the patient with incomplete urethral stricture. VIU is not widely used in the management of the patient with complete urethral stricture, due to the risk of complication. We performed VIU in 10 male-patients had suffered from complete urethral stricture after trauma. We used a flexible Chole-nephroscoper connected with Xenon light source as a guide for the VIU. The length of the urethral stricture was 1.2 +/-0.8 cm. The operation time was 62 +/-26.4 min. The urethral catheter had indwelled for 20.3 +/-17.19 days. All the 10 complete urethral stricture patients became to void successfully. There was no specific serious complication. In conclusion, this method needs only short operative time, had little complication and did not require fluoroscopic guidance. We suggest that this alternative method may be useful and safe for the management of the complete urethral stricture.