What is the place of internal urethrotomy in the treatment of urethral stricture disease?

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dc.contributor.authorNaude A.M.
dc.contributor.authorHeyns C.F.
dc.date.accessioned2011-05-15T16:17:25Z
dc.date.available2011-05-15T16:17:25Z
dc.date.issued2005
dc.description.abstractAs a treatment for male urethral stricture, internal urethrotomy (IU) has the advantages of ease, simplicity, speed and short convalescence. Various modifications of the single cold-knife incision in the 12 o'clock position have been proposed, but there are no prospective, randomized studies to prove their claims of greater efficacy. IU can be performed as an outpatient procedure using local anesthesia, with an indwelling silicone catheter for 3 days after the procedure. Complications of IU are usually minor, including infection and hemorrhage. The reported success rate of IU varies, mainly because of differences in the definition of success and the duration of follow-up. Strictures can recur, usually within 3-12 months of IU. There are several known risk factors for recurrence: a previous IU, penile and membranous strictures, long (>2 cm) and multiple strictures, untreated perioperative urinary infection and extensive periurethral spongiofibrosis. Repeated IU might be useful in patients who have a stricture recurrence more than 6 months after the initial procedure, but repeat IU offers no long-term cure after a third IU, or if a stricture recurs within 3 months of the first IU. Such patients should be offered urethroplasty. Repeated IU followed by long-term self-dilation is an alternative option for men with severe comorbidity and limited life expectancy, or those who have failed previous urethroplasty. Overall, IU has a lower success rate (±60%) than urethroplasty (±80 -90%), but if used for selected strictures, the success rate of IU could approach that of urethroplasty. © 2005 Nature Publishing Group.
dc.description.versionReview
dc.identifier.citationNature Clinical Practice Urology
dc.identifier.citation2
dc.identifier.citation11
dc.identifier.issn17434270
dc.identifier.other10.1038/ncpuro0320
dc.identifier.urihttp://hdl.handle.net/10019.1/14210
dc.subjectantibiotic agent
dc.subjecthalofuginone
dc.subjectmitomycin C
dc.subjectadjuvant therapy
dc.subjectanalgesia
dc.subjectantibiotic prophylaxis
dc.subjectbladder catheterization
dc.subjectcomorbidity
dc.subjectdisease association
dc.subjectdisease severity
dc.subjectfollow up
dc.subjecthuman
dc.subjectincision
dc.subjectindwelling catheter
dc.subjectintermethod comparison
dc.subjectlife expectancy
dc.subjectlocal anesthesia
dc.subjectlong term care
dc.subjectoutpatient care
dc.subjectpatient positioning
dc.subjectpostoperative hemorrhage
dc.subjectpostoperative infection
dc.subjectpriority journal
dc.subjectprostatectomy
dc.subjectrecurrent disease
dc.subjectreoperation
dc.subjectreview
dc.subjectrisk assessment
dc.subjectrisk factor
dc.subjectstent
dc.subjectsurgical approach
dc.subjectsurgical technique
dc.subjecttreatment failure
dc.subjecttreatment outcome
dc.subjecttreatment planning
dc.subjecturethra stricture
dc.subjecturethroplasty
dc.subjecturethrotomy
dc.subjecturinary tract infection
dc.subjecturine flow rate
dc.subjectAlgorithms
dc.subjectHumans
dc.subjectRecurrence
dc.subjectRisk Factors
dc.subjectUrethra
dc.subjectUrethral Stricture
dc.subjectUrologic Surgical Procedures
dc.titleWhat is the place of internal urethrotomy in the treatment of urethral stricture disease?
dc.typeReview
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