Visual Internal Urethrotomy in the Management of Anterior Urethral Stricture

Abstract

Objective: Urethral stricture disease is common in our environment. The aim of this study is to report our experience with visual internal urethrotomy (VIU) in the management of this disease.
Patients and Methods: Seventy male patients with a mean age of 30.6 years were treated for anterior urethral stricture by VIU at the Jos University Teaching Hospital between May 2002 and April 2006. To evaluate the treatment results, we studied the following parameters: stricture etiology, outcome of urethrotomy and complications. All patients were treated as day cases.
Results: The main cause of urethral stricture found in 43 (61.4%) patients was infection
followed by trauma which was found in 11 (15.7%) patients. Twenty fi ve (35.7%) patients had been subjected to previous treatment, notably urethral dilatation. The strictures were bulbar in 62 (88.6%), non-obliterative in 66 (94.3%), single in 28 (40%) and <1cm long in 10 (14.3%) patients. Fifty-six (80%) patients had a satisfactory outcome after a single or second urethrotomy, 10 (14.3%) showed an improvement of symptoms after a third urethrotomy, while in 4 (5.7%) patients urethrotomy failed after four sessions. There was a recurrence rate of 32.9% (n=23), including those who had a good outcome after repeated sessions. Other complications included bleeding in 5 (7.1%), and extravasation in 6 (8.6%) patients. Six (8.6%) patients were admitted for observation because of complications. No mortality was encountered.
Conclusion: VIU is effective and relatively safe for the short-term management of selected
patients with anterior urethral strictures. Patients who do not respond favorably to this modality of treatment should be offered urethroplasty, the outcome of which is not affected by previous internal urethrotomy.


Keywords: Urethrotomy, urethral stricture, visual internal urethrotomy (VIU)

African Journal of Urology Vol. 13 (4) 2007: pp. 267-272