[What is the value of segmental urethrectomy for urethral stenosis in males?]

The authors analyze the results obtained in a homogenous series of 49 patients with urethral stenosis treated by segmental resection of the urethra and end-to-end urethro-urethral suture, with the following conclusions:--Segmental urethrectomy is indicated only for short lengths of stenosis, which do not require the sacrifice of more than 4 cm.--Excellent results were obtained in 41 out of 49 cases (84%).--Good results remain stable, as they were still present in 33 of these 41 successful cases after periods varying from 14 months to 7 years (average: 3 years and 2 months).--Good results have a good chance of remaining as out of the 8 failures only 2 were due to secondary deterioration after a satisfactory initial result. Traumatic and congenital stenoses give the best results as suture of the two healthy sections of the urethra can be performed. Nine successful results were obtained in 10 cases of iatrogenic stenosis after in-dwelling urethral sounds or endoscopic procedures. Twelve cases were successful out of 16 traumatic stenoses of the membranous urethra following pelvic fractures. Two cases of traumatic stenosis of the perineal urethra were both treated with success, as were fourteen out of 15 so-called "congenital" urethral stenoses in which there was no history of trauma or infection. As far as the procedure used is concerned, a successful outcome depends upon the degree of mobilization of the urethral ends, which should be large in order to be able to suture without tension.--The factors causing failure include: absence of excision of post-traumatic callus, insufficient hemostasis, insufficiently prolonged modelling of the suture, favourable for the formation of synechia and, more particularly, a poor condition of the urethra: sclerosed inflammatory stenoses and untreated associated prostatitis.--Sexual impotence is found, temporarily, in all patients operated upon for urethral stenosis, but virility returns in all cases within variable periods of up to two years.