Treatment of urethral strictures

Written by Kelemen Zsolt, Nyirády Péter, Bánfi Gergely

Bouginage or dilatation of the male urethra is not an acceptable method to treat urethra stricture. Endoscopic urethrotomy is the first step in cases of short and non-complicated strictures. It can be repeated once. Open surgery gives the best results. Depending on the origin, place, degree and extension of the stricture different methods are applied for more than 30 years. Resection, circular or augmented anastomosis are the choices for short but extensive strictures. External urethrotomy and widening of urethral lumen was performed by pedicled skin flap but more and more with buccal mucosa in cases of long strictures. Deteriorated urethra in long segment or lichen sclerosus desire a 2 step operation: segmental urethrotomy with or without buccal mucosa graft implantation. Tubularisation is performed 4 to 8 months later. In case of membranosis urethral stricture caused by pelvic fracture pull- thorough operation or bulbo- prostatic anastomosis were managed. Eighty to 90% of our patients are well without significant stricture and do not desire dilatation or epicystostomy.


Keywords: urethral strictures, urology, endoscopic urethrotomy

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