Intermittent urethral self dilatation for prevention of recurrent stricture.
4 Since the introduction of optical internal urethrotomy by Sachse in 1974 using a fine movable scalpel to incise urethral stricture under direct vision, this technique has been used as the primary treatment of new as well as recurrent strictures.
To be included in the study, patients had to have had at least a 6-month cystoscopy or presented with recurrent stricture
prior to the 6-month follow-up.
We also recorded and evaluated the complications including wound infections, development of meatal stenosis, urethrocutaneous fistula formation, recurrent stricture
, erectile dysfunction, penile chordee or deformity, urethral diverticula formation, urinary incontinence or other urinary dysfunctions, lower limb complications due to lithotomy position, and buccal donor site complications.
A study of patients in the UK treated during the period 1991-1999 suggested that a strategy of initial urethrotomy or dilatation followed by urethroplasty for recurrent stricture
is the most cost-effective strategy.
Other patients who can expect an excellent result with the surgery are those who develop complications of GERD such as erosive esophagitis or recurrent stricture
formation while on proton-pump inhibitors and those who experience high levels of gastrin while taking these drugs, he said.
Other patients who can expect an excellent result with surgery are those who develop complications of GERD such as erosive esophagitis or recurrent stricture
formation while on proton pump inhibitors and those who experience high levels of gastrin while taking these drugs.
2], Immediate open realignment of these injuries is associated with an unacceptable high morbidity and a high incidence of recurrent stricture
(69%), urinary incontinence (20%) and erectile dysfunction (40%).
Many authors (22-25) have demonstrated a high success rate of endoscopic primary realignment, following post-traumatic posterior urethral stricture, with management of recurrent stricture
either by repeated dilatation or urethroplasty.
These procedures are associated with a high complication rate, which includes recurrent stricture
, diverticulum formation, and formation of calculi.
The patient was advised to undergo strict surveillance protocols mainly to rule out recurrent strictures
, but the patient never returned for follow-up and continued tobacco chewing, only to return after five years with this huge growth on the proximal shaft.
16-18) In addition, repeated urethrotomies for recurrent strictures
may lead to an increase in the length and depth of fibrosis in some cases.