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Urethral stricture following cardiovascular surgery: role of urethral ischemia

M M Elhilali, M Hassouna, A Abdel-Hakim

    The Journal of Urology
    |February 1, 1986
    PubMed

    Insights

    Cardiovascular surgery patients are at high risk for urethral stricture, especially those with low penile-brachial index. Urethral ischemia and latex catheters significantly contribute to stricture development.

    Area of Science:

    • Urology
    • Cardiovascular Surgery
    • Medical Devices

    Background:

    • Urethral stricture incidence is notably high post-cardiovascular surgery.
    • Identifying causative factors is crucial for patient outcomes.

    Purpose of the Study:

    • To investigate the primary factors contributing to urethral stricture development in male patients after cardiovascular surgery.
    • To assess the correlation between penile hemodynamics and stricture formation.

    Main Methods:

    • Prospective study involving 68 male patients undergoing cardiovascular surgery.
    • Penile-brachial pressure index (PBPI) measurement using strain gauge plethysmography.
    • Analysis of catheter type (latex vs. silicone) and urinary drainage methods.

    Main Results:

    • 15 patients (22%) developed urethral strictures within 3 months post-surgery.
    • 13 of these patients had a PBPI ≤ 0.6 and reported erectile impotence.
    • Latex catheters were used in 11 of the 15 affected patients, while silicone catheters were used in 4.

    Conclusions:

    • Urethral ischemia plays a significant role in stricture development, exacerbated by latex catheter use.
    • Recommend vascular penile studies for patients with erectile impotence undergoing open-heart surgery.
    • Suggest pre-operative cystocatheter diversion for patients with PBPI < 0.6 and recommend silicone catheters for others undergoing open-heart surgery with hypothermia.

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