Abstract

TREATMENT OUTCOMES OF URETHRAL STRICTURE DISEASE FOLLOWING INTERNAL URETHROTOMY AND URETHROPLASTY

Sanchit Gupta*, Vasudevan Thirugnanasambandam, Kalyanram Kone, Deepak David, S. Joseph Philipraj, Abdul Razzack Mossadeq

ABSTRACT

Background: Stricture and fibrosis is the result of wound healing by chronic inflammation resulting in the formation of scar . This applies to inflammation of the urethra as well. Stricture Urethra patients have varied clinical presentations from Irritative to Voiding lower urinary tract symptoms (LUTS). Aims of the study: The aim of the study was to compare the short term treatment outcomes in urethral stricture disease following Visual Internal Urethrotomy and Urethroplasty. Setting and design: Non - randomized prospective study. Methods & Materials: This study was conducted in our institution over a period of 18 months. 29 Men with a diagnosis of Urethral stricture disease belonging to Tamil Nadu region, who underwent Urethroplasty (n=14),VIU(n=14) and Cysto-Dilatation( n=1) were studied. Pre-operative symptom assessment and investigations were done and treatment outcomes such as – Subjective assessment, Objective tests and complications were studied. Statistical Analysis: Pearsons Chi square test, independent T-test, one – way ANOVA, repeated Measure ANOVA were the test used for statistical analysis of data using SPSS 17 software. Results & Conclusions: In the study groups, Uroflowmetry showed significant improvements in both groups at 1, 3 and 6 months follow-up visits. The change in Qmax was observed to be greater with Urethroplasty than with VIU. There is a significant drop in sexual function scores with either Internal Urethrotomy or urethroplasty .There is no statistical significance when comparing Bulbar artery preservation, either unilateral or bilateral, in decreasing the IIEF Score for urethroplasty in stricture disease patients. VIU as a treatment option for patients with short-segment bulbar strictures has a success rate of ~ 60%, with the remaining requiring a secondary procedure within 6 months. Buccal Mucosal Graft Substitution Urethroplasty is a management modality with a high success rate (100%), with limited morbidity and low recurrence in the short-term follow-up.

Keywords: Urethrotomy, Stricture Urethra, Urethroplasty.