Urethrotomy technique in urethral strictures: 6-year results

Our urethrotomy technique for strictures during the last 6 years is analyzed. Each stricture was widened radially over the entire circumference with incisions made close together. In this way a short or moderately long stricture can be eliminated completely in 1 session. For long and multiple strictures only the most distal portion was incised as far as possible. Then, after 2 to 3 weeks, control urethroscopy was done and the remaining stricture subsequently was incised without difficulty using the same technique. Urethrotomy was done with the patient under local anesthesia with mepivacaine because of the better field of view. Instillagel was not used. This technique does not require any followup treatment of the urethra. Since no indwelling catheter is needed foreign body urethritis, which can be the cause of stricture recurrences, is avoided. The postoperative course is shortened greatly. There is greater freedom from complications and the chances of healing are improved. The operation can be performed rapidly and the burden for the patient is slight. Secondary injuries are rare. Sessions can be repeated without complications. Potency is not endangered. This operation can be done on an ambulatory patient with any type of stricture. The late results in 202 patients with simple and complicated strictures who underwent this technique were evaluated. Most strictures were incised in 2 or 3 sessions, which gave the best results. A few complicated callous strictures that had been treated for years with bougienage were incised in 4 or 5 sessions. The over-all success rate of the late results is more than 80 per cent.