Treatment of urethral strictures – comparison of internal urethrotomy (IU) versus primary end to end anastomosis. | [Isra Medical Journal • 2014]

Author(s):

1. Salman Ahmed Tipu: Department of Surgery, Al-Nafees Medical College & Hospital, Isra University, Islamabad Campus, Islamabad, Pakistan

2. Ihtasham Muhammad Ch: Department of Surgery, Al-Nafees Medical College & Hospital, Isra University, Islamabad Campus, Islamabad, Pakistan

3. Omer Shahzad Altaf: Department of Surgery, Al-Nafees Medical College & Hospital, Isra University, Islamabad Campus, Islamabad, Pakistan

4. Ishtiaq Ahmed: Department of Surgery, Al-Nafees Medical College & Hospital, Isra University, Islamabad Campus, Islamabad, Pakistan

5. Asif Zafar Malik: Department of Surgery, Al-Nafees Medical College & Hospital, Isra University, Islamabad Campus, Islamabad, Pakistan

Abstract:

OBJECTIVE: To compare the outcome of Internal Urethrotomy (IU) andPrimary End to End Anastomosis in treating Urethral stictures. STUDY DESIGN: A Cross sectional comparative study PLACE AND DURATION: Razia Saeed Hospital Multan, from 1stApril 2007 to 31st March 2011 METHODOLOGY: A total of 50 patients out of 69 divided into two equal groups of Internal Urethrotomy (IU) and Primary End to End Anastomosis(PEE). Study was conducted between April 2007 and March 2011. Antegraderetrograde Urethrogram was done in all patients to ascertain the size of stricture. Ultra sonography was performed to see the extent of spongiofibrosis.Patients having strictures upto 2 cm in length were selected and underwent the proposed procedures. Both procedures IU and PEE were done under general or spinal anesthesia. RESULTS: The mean patient age was 38 ±10 in IU group and 40± 10 in PEE group. In IU group 2.5% patients got fever, 3.5% had LUTS, and 4% patients visited the causality within 24 hours of session. While in PEE group 6% patients developed LUTS, 8% had fever, 6% patients visited the causality. Hospital stay in case of IU was 1-2 days while it was 3-4 days in PEE group Mean catheter retention time was 6 days in case of IU group while it was 8 days in case of PEE group; catheterization for a longer period did not provide any significant advantage. Symptom free rate after a single procedure was 65% in IU and 72% in PEE group. Complication rate was 10% in IU group whereas it was 13% in LL group. IU is 12% cheaper than PEE. CONCLUSIONS: The groups did not differ greatly as regards primary success. This favours the view that the primary treatment of a short urethral stricture upto 2 cm should be direct vision urethrotomy whenever possible because of the short hospital stay and better cost effectiveness.

Page(s): 208-211

DOI: DOI not available

Published: Journal: Isra Medical Journal, Volume: 6, Issue: 3, Year: 2014

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