Antegrade and retrograde endoscopic manipulation of a complete posterior urethral stricture - Abstract

Purpose: We present our experience in doing an antegrade-retrograde maneuver in the form of cut-to-light or cut-to-sound in treating complete posterior urethral strictures.

Patients and Methods: Between April 2005 and November 2011, 31 patients out of 99 with posterior urethral strictures underwent endoscopic urethral dilation using ureteroscopes (UR) through suprapubic cystostomy and internal urethrotome reterogradely through the urethra. Their ages ranged between 16 to 70 years (mean: 35) and strictures were caused by car accidents in 19 patients, falls astride in 4, gunshots in 3, iatrogenics in 4, and a bomb explosion in 1. The length of the stricture was 4 to 10 mm (mean: 7.6).

Result: Operative time ranged between 20 to 70 minutes (mean: 37.74) and blood transfusion was needed in 2 patients. Cut-to-light was performed in 20 while cut-to-sound was performed in 11. Hospital stay ranged between 1 to 3 days. Catheter stay time was 2 to 4 weeks (mean: 2.4). Twenty-seven patients passed urine smoothly after removal of the catheter, and during a period of observation (10 days), 2 needed transurethral resection of the prostate (TURP) to pass urine strongly, so the success rate is 93.5%. Within 3 to 6 months, another 4 patients needed dilation so the success rate decreased to 80.6%. Another 2 needed dilation after 2 years, so the success rate dropped to 74.2%. Complications were in the form of bleeding in 2 patients and rectal injury in 1. Follow-up ranged between 3 and 24 months.

Conclusion: Antegrade-retrograde visual-internal urethrotomy is safe under supervision of the procedure in complete urethral strictures, so it is more or less acceptable. It markedly decreased operative time, hospital stay, and cost.

KEYWORDS: Antegrade-retrograde, posterior urethral stricture, urteroscope

CORRESPONDENCE: Tawfik Al-Ba’adani, MD, Sana'a University, Thawra Hospital, Sana'a, Yemen ( )

CITATION: UroToday Int J. 2012 October;5(5):art 42.


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