INTRODUCTION: Some studies of primary realignment of urethral stricture show higher long-term complication rates than those observed in patients treated with delayed repair, but the results are not thoroughly documented.
The purpose of this study was to evaluate the results of early endoscopic management of posttraumatic posterior urethral stricture by visual internal urethrotomy (VIU).
METHODS: Participants were 14 males with posterior urethral strictures following a car accident. All patients had partial injuries to the urethra. The strictures were 1-2 cm long. Participant mean age was 21 years (range, 18-26 years). Patients were evaluated by medical history, clinical examination, laboratory investigations, and radiological imaging. VIU was done within 2 weeks of trauma. Follow-up examinations were done at 1, 3, 6, 12, and 24 months after surgery. Outcome measures were flow rates and postoperative complications.
RESULTS: All patients were continent with satisfactory flow rates. One patient had impotence, but his condition was improved at the 6-month follow-up. Other complications included dysuria (n = 5), urinary tract infection (UTI) (n = 2), and urge incontinence associated with UTI (n = 1). After 12 months, 1 patient required surgical intervention due to a decrease in flow rate and recurrence of stricture.
CONCLUSION: Based on this report of 14 patients, early endoscopic urethral realignment surgery is a safe procedure with few complications. Endoscopic restoration of urethral continuity may be considered for early treatment of posttraumatic posterior urethral stricture.
Ahmed Shelbaia
Submitted: March 15, 2011
Accepted for Publication: April 8, 2011
KEYWORDS: Stricture posterior urethra; Early management; Visual internal urethrotomy
CORRESPONDENCE: Dr.Ahmed Shelbaia, MD, Borg Elatbaa, Faisal Street, 5th Floor, Flat 5, Giza, Egypt ( ).
CITATION: UroToday Int J. 2011 Jun;4(3):art43
doi:10.3834/uij.1944-5784.2011.06.13