Evaluation of healing at urethral anastomotic site by pericatheter retrograde urethrogram in patients with urethral stricture

ABSTRACT

Stricture urethra has been always a surgical challenge. Different opinions regarding time require healing at anastomotic site after urethroplasty, so various strategies are there regarding time for post-operative catheter removal. In this study, healing was assessed by pericatheter retrograde urethrogram [PUG] before the catheter removal. Prospective study was conducted from January 2006 to December 2009. Twenty eight cases of short-segment urethral stricture [<2 cm] who underwent urethroplasty were included and divided into two groups depending upon etiology; post-traumatic group [road traffic accident/straddle type injury] and iatrogenic stricture group [due to prolong catheterization/after cystoscopy/Faulty Foleys balloon placement]. Post-operative PUG was done on 14[th] post-operative day in all patients for healing assessment. Extravasation of dye on PUG was taken as anastomotic leak. If the patient had not showed extravasation, the catheter was removed. Otherwise it was kept further for next one week and again PUG was done for healing assessment. Extravasation of dye was noted in 4 patients [33%] of iatrogenic group and 14 patients [87.5%] of the post-traumatic group on 14[th] post-operative day PUG. [P decision to remove catheter was depended upon PUG finding and it was safe, no complication was developed in any patient. Iatrogenic strictures have better healing than post-traumatic stricture in the post-operative period. PUG is a safe and simple procedure and can guide about safe removal of catheter in the post-operative period