The effect of recurrent direct vision internal urethrotomy for short anterior urethral strictures on the disease course and the predictors of treatment failure

  • Hüseyi̇n Aydemi̇r Department of Urology, Sakarya University, Education and Research Hospital, Sakarya
  • Hasan Salih Sağlam Department of Urology, Sakarya University, Education and Research Hospital, Sakarya
  • Osman Köse Department of Urology, Sakarya University, Education and Research Hospital, Sakarya
  • Anıl Erdik Department of Urology, Sakarya University, Education and Research Hospital, Sakarya
  • Fikret Halis Department of Urology, Sakarya University, Education and Research Hospital, Sakarya
  • Ahmet Gökçe Department of Urology, Sakarya University, Education and Research Hospital, Sakarya
Keywords: Internal urethrotomy, recurrence, treatment failure, urethral stricture

Abstract

Introduction: The objective of this study was to investigate the disease course after direct vision internal urethrotomy (DVIU) for short anterior urethral strictures.

Methods: We retrospectively analyzed 94 patients who underwent DVIU of the anterior urethra. Patients’ age, etiology, length and localization of the strictures, total number of DVIU procedures, comorbidities, and other data were evaluated.

Results: The mean age of the patients was 67.2 years. The mean followup duration was 27.1 months. Recurrence was observed in 27.6% of the patients. Recurrence had occurred in these patients at a mean of 12 months. Both the comorbidity score (rs=0.395; p<0.001) and the urinary tract infection (UTI) score (rs=0.492; p<0.001) had significant correlation with the recurrence. In patients with recurrent urethral stricture, as the number of DVIU increased, the length and number of the urethral stricture increased as well. Patients with recurrence had a single stricture in the first DVIU procedure, while the number of strictures increased to a mean of two in the second and/or third DVIU procedures.

Conclusions: DVIU is an effective treatment method in short anterior urethral stricture if it has been applied as a first intervention. However, if the stricture recurs, repeated DVIU application appears to be a negative predictive factor. The presence of perioperative treated UTI, smoking, and total number of comorbidities were negative predictive factors for the recurrence of urethral stricture. The disadvantages of our study are that it is retrospective, it includes a low number of patients, and the followup period is short.

Published
2019-01-21
How to Cite
Aydemi̇rH., Sağlam, H. S., Köse, O., Erdik, A., Halis, F., & Gökçe, A. (2019). The effect of recurrent direct vision internal urethrotomy for short anterior urethral strictures on the disease course and the predictors of treatment failure. Canadian Urological Association Journal, 13(11), E366-70. https://doi.org/10.5489/cuaj.5754
Section
Original Research