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41. Stricture Urethra - Management and Outcome

Zein el Amir, Zeeshan Qadeer, Umer Javed Chughtai, Mirza Hammad Rauf, Ayesha Mushtaq and Rameez Ahmed Mughal

ABSTRACT

Objective: The objective of our study was to determine different modalities of treatment opted, in respect varying presentation of urethral stricture.

Study Design: Descriptive study.

Place and Duration of Study: This study was conducted at the Department of Urology, Benazir Bhutto Hospital, Rawalpindi from November 2017 to November 2019.

Materials and Methods: A total of 115 patients diagnosed to have stricture urethra and admitted through outdoor department were included in the study. Retrograde urethrography either alone or with antegradecystogram was done. Management was done according to cause, urethral dilatation, optical urethrotomy and urethroplasty was performed. Success was determined by no need for further intervention or establishment of maximum flow rate >20ml/sec with 200 ml voided urine. All the patients were selected using retrograde urethrography either alone or with antegradecystogram. Written informed consent was taken from every patient before taking history and examination. The permission of Ethical Committee was taken before collecting the data and get publishing in Medical Journal. The data was analyzed for results by SPSS version 20.

Results: A total of 115 patients admitted between 8-90 years (Mean age 45 years). 65 (56.52%) patients presented with complaint of lower urinary tract symptoms (LUTS), while 50 (43.47%) had acute urinary retention for which suprapubic urinary diversion was done. Common causes included iatrogenic injury in69 (60%)& 30 (26.28%) with external trauma. 80 (69.56%) patients were treated by optical urethrotomy, 23 (20%) underwent urethroplasty, 17 (14.78%) were treated by anastomotic urethroplasty and 6 (5.21%) by substitution urethroplasty. 10 (8.69%) patients with submeatal stricture, boogie’s dilatation was done. Patients unfit for surgery were managed with suprapubic urinary diversion under local anesthesia 2 (1.73%). According to investigations that were done before management, 62 (53.91%) had a stricture at bulbomembranous junction, 32 (27.82%) had stricture in bulbar urethra, 10 (8.69%) patients had submeatal stricture, 7 (6.28%) of them had a stricture in penile urethra and 4 (3.47%) patients had stricture in membranous urethra.

Conclusion: This study revealed most of the soft and short strictures can be treated by optical urethrotomy, however lengthy and complex strictures require either anastomotic, augmentation or substitution urethroplasty as a definitive treatment.

Key Words: Outcomes, Complications Urethral stricture, Optical Urethrotomy, Urethroplasty, Urethra, Urethral Dilatation

Citation of article: Amir Z, Qadeer Z, Chughtai UJ, Rauf MH, Mushtaq A, Mughal RA. Stricture Urethra - Management and Outcome. Med Forum 2021;32(3):168-171.