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Direct visual internal urethrotomy: Is it a durable treatment option?
Dilip Kumar Pal1, Sanjay Kumar1, Bastab Ghosh1
1Department of Urology, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India.
Urology Annals
|February 21, 2017
Summary
Direct vision internal urethrotomy (DVIU) for anterior urethral strictures shows disappointing long-term success rates. Stricture-free probabilities decrease significantly after each subsequent DVIU procedure.
Area of Science:
- Urology
- Surgical Procedures
- Anterior Urethral Strictures
Background:
- Anterior urethral strictures are a common urological condition.
- Direct vision internal urethrotomy (DVIU) is a minimally invasive treatment option.
- Long-term efficacy of DVIU for anterior urethral strictures requires further evaluation.
Purpose of the Study:
- To assess the long-term success rate of DVIU in treating anterior urethral strictures.
- To determine the stricture-free probability after repeated DVIU procedures.
Main Methods:
- Retrospective analysis of 186 patients undergoing DVIU for anterior urethral strictures (2009-2014).
- Exclusion of patients with complex strictures (prior urethroplasty, hypospadias repair, radiation).
- Kaplan-Meier analysis to calculate stricture-free rates after first, second, and third urethrotomies.
Main Results:
- Stricture-free rates after the first, second, and third DVIU were 29.66%, 22.64%, and 13.33%, respectively.
- A significant decline in success rates was observed with repeat procedures.
Conclusions:
- DVIU may serve as an initial management option for anterior urethral strictures.
- The long-term outcomes of DVIU for anterior urethral strictures are generally disappointing.
- Repeated DVIU procedures demonstrate diminishing success rates over time.