Percutaneous transvesical antegrade passage of urethral strictures

Failure to pass a urethral stricture by retrograde instrumentation is generally accepted as excluding the possibility of closed internal urethrotomy. In 2 patients with impassable strictures percutaneous transvesical antegrade passage of a guide wire through the stricture was successful, paving the way for balloon dilatation of the stricture and visual internal urethrotomy. In view of the success rate of internal urethrotomy in treating strictures, it is recommended that this radiological method of dealing with an impassable stricture from above be used to avoid open operation and to allow internal urethrotomy to proceed. A protocol for the procedure is suggested.