STRICTURE URETHRA

A IMS & OBJECTIVES: 1. To demonstrate different etiological factors of stricture urethra. 2. To demonstratedifferent anatomical sites of urethra involved. 3. To describe management as being done at Allied Hospital, Faisalabadand suggest methods to improve it. STUDY DESIGN: Prospective. SETTING: Allied Hospital, Faisalabad.PERIOD: April 1996 to Aug 1998. PATIENTS & METHODS: A total of 100 consecutive male patients rangingfrom 6-80 years presenting to Surgical Unit II of Allied Hospital, Faisalabad with clinical diagnosis of stricture urethrawere included in the study. After history and examination, baseline investigations and retrograde urethrography wereperformed in all patients and micturating cystourethrography in patients with blind strictures. Treatment as being donewas also recorded. Follow up ranges from 4-24 months. RESULTS: Trauma was the most common cause of urethralstricture. Fracture pelvis alone was responsible for half of the strictures while straddle injury accounted for another 20%.The incidence of iatrogenic, infective and congenital stricture was found to be 24%, 4% and 2% respectively. Most of theposterior urethral strictures (86%) were due to indirect urethral trauma (fracture pelvis). Anterior urethra was the site ofinfective, congenital and iatrogenic strictures as well as strictures following direct urethral trauma. Internal urethrotomywas the treatment of first choice and was performed in 73% patients with satisfactory results. Urethroplasty was performedin 27% patients. Clean Intermittent Self Catheterization and active urethral dilatation was performed as adjuvanttreatment to prevent the recurrence of stricture. CONCLUSIONS; The etiological factors of stricture urethra andanatomical sites involved are comparable to international literature. Internal Urethrotomy is safe and reliable procedurefor simple urethral strictures while urethroplasty should be considered for complex strictures. Active urethral dilatation atrepeated intervals still has a role in preventing recurrence or stricture after initial treatment with internal urethrotomy andurethroplasty.