Comparative Analysis in Methods of Operation of Urethral Stricture and Long Term Follow-up

Lee, Dong Hwan; Lim, Su Kil

Abstract

Urethral stricture is one of the most serious disease in Urology and must be treated vigorously, but the best method of treatment is not established. Our aim is to evaluate a policy of treatment which had developed in favor of urethroplasty for all but minor stricture. A total of 123 patients who had suffered from urethral stricture and undergone urethroplasty in the Department of Urology. Catholic Medical College, were studied during the period from January, 1970 to December, 1982. Of 123 patients,112 primary operations were interlocking, resection and end-to-end anastomosis, Turner-Warwick urethroplasty and transpubic urethroplasty. The results were as follows: 1. In age distribution of the 123 cases of urethral stricture, age of 80 cases ranged from 20 to 49 years. 2. The most common cause of urethral stricture was traumatic urethral injury(traffic accident, industrial accident and staddle injury)comprising 117(95.1%)our of 123cases and the remainders were inflammatory in 3(2.4%),iatrogenic in 3(2.4%). 3. In 41 cases(36.6%)repair was done by interlocking,57(50.9%)by resection and end-to-end anastomosis,3 (2.7%)by Turner-warwick urethroplasty,1(0.9%)by transpubic urethroplasty, 10(8.9%)by suprapubic cystostomy alone. 4. Of the 41 cases of interlocking,6(14.6%) were developed stricture and they required a secondary operation due to persistent stricture in spite of urethral dilatation. 5. Of the 57 cases of resection and end-to-end anastomosis, 5(8.8%)were developed stricture and they required a secondary operation. 6. The methods of secondary operation were resection and end-to-end anastomosis in 6, Turner-Warwick urethroplasty in 2, transpubic urethroplasty in 2.9 of the 10 had good results but 1 required a tertiary operation. 7. In 11 cases transferred from other hospital, methods of secondary operation were resection and end-to- end anastomosis in 8,Turner-Warwick urethroplasty in 2, transpubic urethroplasty in 1 but 3 of the 11 cases required a tertiary operation(Turner-Warwick urethroplasty.) 8. Impotence was developed in 17(13.8%) and the incidence of impotence associated with pelvic bone fracture was 11 cases(64.7%) In total 123 urethral stricture patients,55cases have been followed up by interview and questionnaire from 2 to 10 years. 68 were lost to follow-up. 2 of the 55 vases died of unrelated disease within the period of follow-up. In long term follow-up survey of 53 cases, 7(13.2%) were complicated of urethral stricture and impotence in 9 (17.0%).