Abid Bashir, Safdar Sial, Yousaf Shah, Shuja Tahir.
Stricture Urethra; A clinical study of 100 consecutive cases at Allied Hospital, Faisalabad.
Professional Med J Jan ;9(2):159-68.

AIMS & OBJECTIVES: 1. To demonstrate different etiological factors of stricture urethra. 2. To demonstrate different anatomical sites of urethra involved. 3. To describe management as being done at Allied Hospital, Faisalabad and suggest methods to improve it. STUDY DESIGN: Prospective. SETTING: Allied Hospital, Faisalabad. PERIOD: April 1996 to Aug 1998. PATIENTS & METHODS: A total of 100 consecutive male patients ranging from 6-80 years presenting to Surgical Unit II of Allied Hospital, Faisalabad with clinical diagnosis of stricture urethra were included in the study. After history and examination, baseline investigations and retrograde urethrography were performed in all patients and micturating cystourethrography in patients with blind strictures. Treatment as being done was also recorded. Follow up ranges from 4-24 months. RESULTS: Trauma was the most common cause of urethral stricture. Fracture pelvis alone was responsible for half of the strictures while straddle injury accounted for another 20%. The incidence of iatrogenic, infective and congenital stricture was found to be 24%, 4% and 2% respectively. Most of the posterior urethral strictures (86%) were due to indirect urethral trauma (fracture pelvis). Anterior urethra was the site of infective, congenital and iatrogenic strictures as well as strictures following direct urethral trauma. Internal urethrotomy was the treatment of first choice and was performed in 73% patients with satisfactory results. Urethroplasty was performed in 27% patients. Clean Intermittent Self Catheterization and active urethral dilatation was performed as adjuvant treatment to prevent the recurrence of stricture. CONCLUSIONS; The etiological factors of stricture urethra and anatomical sites involved are comparable to international literature. Internal Urethrotomy is safe and reliable procedure for simple urethral strictures while urethroplasty should be considered for complex strictures. Active urethral dilatation at repeated intervals still has a role in preventing recurrence or stricture after initial treatment with internal urethrotomy and urethrophasty

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