Management of stricture urethra

ABSTRACT

To determine the role of internal optical urethrotomy [IOU] alone arid IOU followed by clean intermittent self catheterization [CISC] in the management of the uretheral stricture disease and to investigate the effect of CISC or prevention of urethral stricture recurrence after IOU. The study was carried out in the Department of Urology, Nishtar Hospital, Multan from January 1997 to December 1999. A total of 37 patients were included in the study. Most of strictures [5 1%] resulted from some sort of trauma while infections and indewelling urinary catheters were responsible for strictures in 21% patients and 13.5% respectively. Three patients had post prostatectomy strictures and in 2 patients etiology remained unknown. Patients commonly presented with symptoms and difficulty with micturition [94%], poor flow [75%] and split stream in 62%. Three patients [23%] in group-A developed recurrence of uretheral stricture within first year while stricture recurred in 12 patients [75%] in group-B. In 14 [37%] patients some complications occurred after IOU. In these patients bleeding was commonest complication [18%] followed by infection and urinary extravastion 5% and 16% respectively. Optical urethrotomy is a safe and effective means to manage urethral strictures, its success rate approaches 70% with simple strictures less than 2 cm in length in selected group of patients. It can be performed under spinal or general anaesthesia