A New Diagnostic Method for Urethral Stricture in Concomitant Retrograde and Voiding Cystourethrography Using Alpha Adrenoceptor Blocker

Park, Jong Kwan

Abstract

The treatment of traumatic disruption of the urethra must be tailored to the anatomical situation. It is too hard to know true length and situation of urethral stricture by concomitant retrograde and voiding cystourethrography, due to the bladder neck failed to open usually, Sometimes urologist have performed cystoscope or sound through by suprapubic cystostomy on retrograde urethrography to confirm the length of the urethral stricture. But these methods are complicated and invasive. Alpha adrenoceptor has been known to do important role in the bladder neck and prostatic urethra. So alpha adrenoceptor blocker( terazosin) has been used to decrease tone of internal urethral sphincter of the patient with benign prostatic hypertrophy. Under that theory, we tried terazosin per oral route when we performed the concomitant retrograde and voiding cystourethroscopy in 3 patients with complete membranous urethral stricture and 3 patients with bulbomembranous and 2 patients with bulbar urethral stricture. Dosage of terazosin was 1 to 10mg. The length and site of the stricture were not visualized by usual method without terazosin. In that cases we performed concomitant retrograde and voiding cystourethrography 1 hour after intake of terazosin. Terazosin well visualized site of the urethral stricture in 7 patients who had intact internal urethral sphincter.