Endoscopic Management of Traumatic Posterior Urethral Stricture: Early Results and Followup

No AccessJournal of UrologyClinical Urology: Original Article1 Jan 1997Endoscopic Management of Traumatic Posterior Urethral Stricture: Early Results and Followup Mahesh C. Goel, Mayank Kumar, and Rakesh Kapoor Mahesh C. GoelMahesh C. Goel More articles by this author , Mayank KumarMayank Kumar More articles by this author , and Rakesh KapoorRakesh Kapoor More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(01)65295-9AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We assessed the outcome of core through internal urethrotomy for traumatic posterior urethral stricture, and reviewed the followup results of these patients. Materials and Methods: During the last 4 years 13 patients with a stricture up to 2 cm. long underwent core through internal urethrotomy with C-arm fluoroscopy guidance and an orientation in 2 planes. Retrograde urethrotomy was performed and an 18F Foley catheter was left indwelling for 4 weeks, after which urethrotomy was repeated. All patients were advised to perform clean intermittent self-catheterization for urethral calibration and dilation. Outcome was defined as class 1-3 patients who required 2 or fewer urethrotomies with clean intermittent self-catheterization discontinued after the primary procedure, class 2-5 who required 2 or fewer urethrotomies with clean intermittent self-catheterization and class 3-5 who required 3 or more urethrotomies. Results: Of the 13 patients 8 (61%) did well after a mean followup of 17.7 months. The 3 patients with a class 1 outcome did well, while 2 of 5 with a class 2 outcome required repeat urethrotomy during followup. Of the 5 patients (39%) with a class 3 outcome in whom core through internal urethrotomy failed 3 required open surgery and 2 were lost to followup. Recurrence rate was 69% at 3 months and 25% at 12 months after the initial procedure. No patient was incontinent at last followup. Two patients had significant hematuria postoperatively, which resolved with conservative treatment. Conclusions: Endoscopic treatment should be considered the first line procedure for all posttraumatic posterior urethral strictures. The morbidity of open surgery can be avoided in 61% of patients. Hospital stay, loss of work, morbidity and related complications are also markedly decreased with endoscopic therapy. References 1 : Rupture of the posterior urethra.. J. Urol.1972; 107: 255. Abstract, Google Scholar 2 : Immediate realignment of posterior urethral injury.. Urol. Clin. N. Amer.1977; 4: 75. Google Scholar 3 : The surgical repair of membranous urethral strictures: experience with 105 consecutive cases.. J. Urol.1980; 123: 500. Abstract, Google Scholar 4 : Posterior urethral stricture repair.. J. Urol.1979; 121: 739. 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Abstract, Google Scholar Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India.© 1997 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited ByOh M, Jin M, Sung D, Yoon D, Kim J and Moon D (2018) Magnetic Resonance Urethrography to Assess Obliterative Posterior Urethral Stricture: Comparison to Conventional Retrograde Urethrography With Voiding CystourethrographyJournal of Urology, VOL. 183, NO. 2, (603-607), Online publication date: 1-Feb-2010.DOGRA P and NABI G (2018) CORE-THROUGH URETHROTOMY USING THE NEODYMIUM: YAG LASER FOR OBLITERATIVE URETHRAL STRICTURES AFTER TRAUMATIC URETHRAL DISRUPTION AND/OR DISTRACTION DEFECTS: LONG-TERM OUTCOMEJournal of Urology, VOL. 167, NO. 2 Part 1, (543-546), Online publication date: 1-Feb-2002.DOGRA P, ARON M and RAJEEV T (2018) CORE THROUGH URETHROTOMY WITH THE NEODYMIUM: YAG LASER FOR POSTTRAUMATIC OBLITERATIVE STRICTURES OF THE BULBOMEMBRANOUS URETHRAJournal of Urology, VOL. 161, NO. 1, (81-84), Online publication date: 1-Jan-1999. Volume 157Issue 1January 1997Page: 95-97 Advertisement Copyright & Permissions© 1997 by American Urological Association, Inc.MetricsAuthor Information Mahesh C. Goel More articles by this author Mayank Kumar More articles by this author Rakesh Kapoor More articles by this author Expand All Advertisement Loading ...