Horiguchi A, et al. - Clinicians analyzed the effect on urethral stricture complexity at urethroplasty of previous transurethral treatments such as dilation, urethrotomy, and stenting which are used most commonly when treating male urethral stricture. It was showed that repeated transurethral treatments increase stricture complexity and are potentially counterproductive. Moreover, even a single use of temporary urethral stenting has a high risk of complicating the stricture and requiring the use of a complex urethroplasty.

Methods

• Clinicians retrospectively examined the records of 45 males who had undergone transurethral treatments before urethroplasty and compared their urethrography findings at initial diagnosis with those at urethroplasty.
• In this study, males with failed hypospadias repair, lichen sclerosis, or history of prior urethroplasty were excluded.
• They considered stricture complexity increased if the number of strictures and/or stricture length on the urethrography at urethroplasty was greater than that at initial diagnosis or if false passage was newly distinguished.

Results

• It was noted that 39 (87%), 32 (71%), and 13 (29%) had received urethral dilation, urethrotomy, and urethral stenting, respectively, and 39 (87%) had received repeated or multiple kinds of transurethral treatments.
• They exhibited evidence that stricture complexity was increased in 22 (49%), and seven (16%) required an urethroplasty more complex than that anticipated from urethrography findings at initial diagnosis.
• They observed that increased stricture complexity was significantly correlated with histories of urethrotomy (p = 0.03), urethral stenting (p = 0.0002), and repeated transurethral treatments (p = 0.01).
• In this multivariate analysis, they revealed that urethral stenting (p = 0.01) and repeated transurethral treatments (p = 0.01) were independent predictors of increased stricture complexity.