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Hydraulic urethral dilatation after optical internal urethrotomy: preliminary report
1Department of Surgery, Muhimbili University College of Health Sciences, Dar es Salaam, Tanzania.
Objectives:
To determine the rate of early recurrence of urethral stricture in the first six months in patients who perform hydraulic urethral dilatation(HUD) after optical internal urethrotomy (OIU) and compare the early recurrence rate in patients who perform HUD after OIU with the recurrence rates in patients reported in the literature who undergo OIU without performing HUD.
Design:
Prospective descriptive case series.
Settings:
Urology clinic, Muhimbili Medical Centre, Dar es Salaam, Tanzania.
Subjects:
Patients with symptoms of urethral stricture subsequently radiologically demonstrated to have urethral stricture that was deemed treatable by OIU.
Interventions:
Evaluation included urethrography, renal biochemical profile and urethroscopy at the time of OIU. Patients with strictures no longer than 50 mm, no complete block or marked tortuousness, and no paraurethral sepsis were selected for OIU, urethral catheter for seven days followed by HUD) for one month.
Results:
During a follow up period of five to seventeen months (mean 10.1 months), only two out of twenty three patients (8.7%) showed clinical evidence of stricture recurrence. The remaining patients reported normal voiding.
Conclusion:
This report suggests that HUD, a cost-free technique, is an effective method for preventing stricture recurrence after OIU. As follow up of these and subsequent patients continue, it is hoped that this not-so-well-known technique will undergo evaluation at other centres in our region.