Visual internal urethrotomy in short segment bulbar stricture

Vedamurthy Reddy Pogula; Ershad Hussain Galeti; Kashinath Vasanth Thakare; Venkatesh Velivela; Sandeep Reddy; Ayesha Galeti

doi:10.5455/nmj/00000208

Abstract
Background: Visual internal urethrotomy is a quiet, smooth and popular treatment for male short segment bulbar stricture. The Success Rates are not promising compared to urethroplasty. Among distinct factors, the percentage of narrowing at the maximum stricture point on a retrograde urethrogram is least studied. This study aimed to evaluate the outcome of visual internal urethrotomy in the management of patients with short segment bulbar urethral stricture.
Methods: A total of 40 male patients with short segment bulbar urethral stricture who underwent visual internal urethrotomy from May 2018 to February 2020 were studied. We used retrograde urethrogram to assess the stricture site narrowing and Percentage of narrowing was measured. The patients were then subjected to visual internal urethrotomy using a standard 21fr Sachse's cold knife urethrotome. The preoperative and postoperative uroflowmetry, mean voided volumes were measured at 3rd and 6th months respectively to evaluate the effect of visual internal urethrotomy.
Results: The majority of the patients were in the age group of 31-40 years. The mean bulbar urethral stricture length was 1.3 cm. Idiopathic was the commonest cause of stricture in 22 (55%) patients. The postoperative uroflowmetry changes and mean voided volume were improved significantly at the 3rd and 6th months. The recurrence rate was 25% for length ≥ 2cm and 8.33% for length <2cm. Patients with mild to moderate spongiofibrosis have got 100% success rate. Those patients who had severe spongiofibrosis have got a recurrence rate of 36.4%. In the failure patients most of the recurrences occurred in the first year.
Conclusion: Visual Internal Urethrotomy is a safe and time effective procedure for the treatment of short segment bulbar urethral strictures with mild to moderate spongiofibrosis in male patients as a short term treatment. Percentage narrowing of the urethral lumen at the stricture site is a useful predictor of visual internal urethrotomy outcome.

Key words: Stricture urethra; visual internal urethrotomy; uroflowmetry

	Open Access and Peer-reviewed
Home Journal Issues Guide for Authors Editorial Board Aims & Scope About Journal News & Announcements

ABOUT JOURNAL About Publisher Contact Us Editorial & Peer Review Process	POLICIES Privacy Policy Editorial Policy Author's Rights and Obligations Conflict of Interest Policy Plagiarism Policy Advertising Policy	STATEMENTS Terms of Use Author's Rights and Obligations Publication Ethics and Publication Malpractice Statement Protection of Research Participants (Statement On Human And Animal Rights) License Information

How to cite this article