STRICTURE URETHRA

A CLINICAL STUDY OF 100 CONSECUTIVE CASES AT ALLIED HOSPITAL, FAISALABAD.

Abstract

A IMS & OBJECTIVES: 1. To demonstrate different etiological factors of stricture urethra. 2. To demonstrate
different anatomical sites of urethra involved. 3. To describe management as being done at Allied Hospital,
Faisalabad and 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 ranging from 6-80 years presenting to Surgical Unit II of Allied Hospital, Faisalabad with clinical diagnosis
of stricture urethra were included in the study. After history and examination, baseline investigations and retrograde
urethrography were performed in all patients and micturating cystourethrography in patients with blind strictures.
Treatment as being done was also recorded. Follow up ranges from 4-24 months. RESULTS: Trauma was the most
common cause of urethral stricture. 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 the posterior urethral strictures (86%) were due to indirect urethral trauma
(fracture pelvis). Anterior urethra was the site of infective, congenital and iatrogenic strictures as well as strictures
following direct urethral trauma. Internal urethrotomy was the treatment of first choice and was performed in 73%
patients with satisfactory results. Urethroplasty was performed in 27% patients. Clean Intermittent Self
Catheterization and active urethral dilatation was performed as adjuvant treatment to prevent the recurrence of
stricture. CONCLUSIONS; The etiological factors of stricture urethra and anatomical sites involved are comparable
to international literature. Internal Urethrotomy is safe and reliable procedure for simple urethral strictures while
urethroplasty should be considered for complex strictures. Active urethral dilatation at repeated intervals still has a
role in preventing recurrence or stricture after initial treatment with internal urethrotomy and urethroplasty.