Urethrotomy has a much lower success rate than previously reported

Area of Science:

• Urology
• Surgical Procedures

Background:

• Male urethral strictures are a common condition requiring treatment.
• Direct vision internal urethrotomy is a frequently utilized, minimally invasive option.

Purpose of the Study:

• To evaluate the success rate of direct vision internal urethrotomy for simple male urethral strictures.
• To determine the long-term efficacy of repeated urethrotomy procedures.

Main Methods:

• Retrospective chart review of 136 patients undergoing urethrotomy (1994-2009).
• Kaplan-Meier analysis to assess stricture-free probability after 1-5 urethrotomy procedures.
• Exclusion of complex strictures and patients lost to follow-up.

Main Results:

• Data available for 76 patients; stricture-free rates were low across all procedures (1st: 8%, 2nd: 6%, 3rd: 9%, 4th/5th: 0%).
• Median time to recurrence was consistently short, ranging from 3 to 20 months.
• Long-term success rate for any number of urethrotomies was estimated at 0%.

Conclusions:

• Direct vision internal urethrotomy demonstrates poor performance characteristics for male urethral strictures.
• Success rates do not exceed 9% for initial or subsequent procedures.
• Urethrotomy should be considered a temporizing measure, not a definitive cure.