The Role of Optical Internal Urethrotomy for Male Urethral Stricture

Introduction: Urethral stricture is characterized by a decrease in urethral flow severe enough to cause acute urinary retention. Urethral strictures may develop after traumas to the urethral epithelium and/or corpus spongiosum. Complication rates due to untreated urethral stricture are very high. Although various treatment methods have been described, the second most common method for urethral dilation in practice is cold knife internal urethrotomy. The purpose of this study is to evaluate data from patients who were treated with internal urethrotomy in our clinic. Methods: This study included patients who were treated with urethral urethrotomy due to internal stricture between January 2011 and May 2015. Demographic, clinical, radiological, uroflowmetric (maximum and mean urine flow rate) and relevant data of the patients were retrospectively evaluated and recorded. Results: This study included 155 patients with a mean (± standard deviation) age of 71.70 (± 13.7). Etiologically the most common reason was urological surgical procedures (67%), and the most common stricture was seen at bulbomembranous urethra region (85.2%). The mean length of stricture was 5.4 ± 2.4 mm. Mean duration to remove the catheter was 1.8 ± 1.3 days. Regional anesthesia was used in 67.7% of the patients. Our success rate was 78.1%. Comparison of maximum and mean urine flow rates preand postoperatively revealed significant increases postoperatively. Conclusion: Internal urethrotomy is a first line treatment method for urethral strictures because it is easily applied, has a low complication rate, and can be applied with local anesthesia in high-risk patients who are unable to take general anesthesia. Although recurrence rate is high, repeatability is its greatest advantage, and it causes significant relief in patients with urethral strictures, but it must be kept in mind that definitive treatment is urethroplasty.