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Year : 2017  |  Volume : 30  |  Issue : 2  |  Page : 367-371

Evaluation of direct visual internal urethrotomy in the management of anterior urethral strictures

Urology Department, Faculty of Medicine, Menoufia University, Menoufia, Egypt

Correspondence Address:
Ibrahim M Gomaa
Urology Department, Faculty of Medicine, Menoufia University Menoufia 11160
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1110-2098.215438

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Objectives The aim of the present study was to evaluate the outcome of direct vision internal urethrotomy (DVIU) in the management of patients with anterior urethral stricture. Background DVIU is a simple and popular treatment for male urethral stricture; however, the long-term stricture-free rate is modest even after only a single procedure. Therefore, identifying patients at risk for recurrence after DVIU is crucial. There is a paucity of research regarding factors predicting failure after DVIU, notably with no standardized definition of failure. Patients and methods We reviewed the charts and retrospectively analyzed the records of 103 male patients who underwent DVIU for anterior urethral stricture disease at Menoufia University Hospital between June 2014 and June 2015. The patients' demographics and stricture characteristics were analyzed. Procedure failure was defined as the need for regular urethral dilatation, redo DVIU, or urethroplasty. In addition, predictors of failure were analyzed. Results Successful outcome had occurred in 51 patients. The site of stricture was bulbar in 72.5% of them, whereas it was bulbopenile in 23.5% and penile in 4% of them. Stricture length was less than 1 cm in 51% of them, whereas it was 1–2 cm in 49% of them. Conclusion Patients with urethral stricture who are ideal candidates for initial treatment with DVIU tend to have a single, short (≤1 cm) bulbar stricture and no extensive spongiofibrosis surrounding the stricture. Repeated DVIU should be considered only in patients who are poor surgical candidates and not because of the convenience of performing a simple procedure.

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