DOI: http://dx.doi.org/10.18203/2349-2902.isj20200534

Study of treatment options in stricture urethra management and success rate in different types and sites of stricture

Krishna Rao S. V., Preetam Penumatcha

Abstract


Background: A urethral stricture is a scar of the subepithelial tissue of the corpus spongiosum that constricts the urethral lumen. As the constriction progresses, obstruction develops and leads to symptoms either directly related to the obstruction or as a secondary consequence.

Methods: All the cases of stricture urethra presented to our institute between June 2017 to June 2019 (n=60) in whom treatment was required were studied in a prospective manner. All cases of obstructive voiding symptoms are evaluated by conducting uroflowmetry studies (ESPON, gravimetric type). Obstructive voiding symptoms are evaluated by using the American Urological Association questionnaire.

Results: The data collected was divided into 3 groups: infective causes of stricture (n=22), traumatic causes of stricture (n=14) and idiopathic causes of stricture (n=24). The mean age of presentation was 34.4 years (range of 20 to 50 years). 18 (30.00%) patients had stricture in the bulbo-urethra, 12 (20.00%) at the external meatus, 4 patients had stricture at the bulbo-membranous region. Procedures undertaken during the study were visual internal urethrotomy in 20, anastomotic urethroplasty in 17 patients and Augmented urethroplasty in 23 patients. In our series of 60 patients, 48 patients had a Qmax of >15 ml/sec.  Average success rate was 80.1%, 12 patients had a Qmax of <15 ml/sec.

Conclusions: It is unwise to make sweeping recommendations for best practice for reconstructive urethral surgery based on the literature because each patient clearly requires an individualized approach based on individual circumstances. Buccal mucosa is the most widely used graft has excellent results in all types of urethroplasty.


Keywords


Buccal mucosal graft, Stricture, Urethroplasty, Urethrotomy

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References


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