Balloon dilatation for male urethral strictures "revisited"

ABSTRACT

To analyze the results of balloon dilatation for short segment male urethral strictures. Retrospective analysis was done on 120 patients undergoing urethral balloon dilatation since January 2004 to January 2012. The inclusion criteria for analysis was a short segment [less than 1.5 cm] stricture, exclusion criteria were pediatric, long [more than 1.5 cm], traumatic, malignant strictures. The parameters analyzed included presentation of patients, ascending urethrogram [AUG] and descending urethrogram findings, pre- and postoperative International prostate symptoms score [IPSS], uroflowmetry [Q max], and post-void residue [PVR]. Need for self calibration/ancillary procedures were assessed. Failure was defined as requirement for a subsequent endoscopic or open surgery. A urethral balloon catheter [Cook Urological, Spencer, Indiana] is passed over a guide wire after on table AUG and inflated till 180 psi for 5 minutes under fluoroscopy till waist disappears. Dilatation is followed by insertion of a Foley catheter. Patients were followed up at 1, 3, and 6 months. Mean age was 49.86 years. Mean follow-up was 6 [2-60] months. IPSS improved from 21.6 preoperative to 5.6 postoperatively. Q[max] increased from 5.7 to 19.1 and PVR decreased from 90.2 to 28.8 [P < 0.0001*] postoperatively. At 1, 3, and at 6 monthly follow-up, 69.2% [n = 82] patients were asymptomatic. Balloon dilation is a safe, well-tolerated procedure with minimal complications. Further randomized studies comparing balloon dilatation with direct internal visual urethrotomy are warranted