[Strictures of the proximal urethra in men]

Stricture of proximal male urethra remains complicated problem of urology. Surgical intervention conducted at sphincter area is fraught with the damage of potential enuresis. A total of 250 patients with proximal urethra strictures were treated. Most of them could recover normal uresis. Unlike strictures of inflammatory origin, those of traumatic and secondary genesis presented great difficulties for management in view of both sphincters impairment. To be successful, urethral operations must follow the following main principles: maximal preservation of the sphincter apparatus, radical removal of the cicatricial tissue, adequate urine elimination, reliable hemostasis. None of operations could at present meet the above requirements, the worst results being obtained after Solovov's technique surgery (25% of enuresis outcomes in 4 out of 16 treated). Endourethral surgery can produce good results, especially effective interventions being reported in short strictures and underdevelopment in paraurethral tissue. Bougienage remains a forced measure in managing urethral strictures combined with infravesicular obstruction and sphincter insufficiency. Positive long-term results were achieved in 182 patients treated. It is suggested that controlled uresis could be reestablished in absolute majority of cases.