V.P. Stus, A.L. Suvaryan, E.P. Ukrainian

Our experience in the treatment of urethral strictures

Treatment of urethral strictures still remains one of the most difficult problems of reconstructive urology. From 2008 to 2014 in urology clinic in Dnipropetrovsk Regional Clinical Hospital of I.I Mechnikov 81patients treated with urethral stricture, aged 22-75 years (med. 46.15 years), the length of the stricture from 2 to 145 mm (med. 22,37 mm.). Terms observation of patients after surgical treatment ranged from 3 to 36mant. Internal optical urethrotomy (IOU) - 29. Urethral stricture recurrence after the first 12 months of IOU appeared in 18 (62.1%) and was accompanied by significant complications - 9 (31.03%) of patients. The length of the stricture after each IOU increased 2-8 mm. Anastomatic urethroplasty held on 21 patients. The length of the stricture from 8 to 37mm. Complications occurred in 1 (4.76%) patients. Urethroplasty using buccal mucosa carried out in 14 patients. The length of stricture 38 to 145. Complications occurred in 1 (7.14%), recurrence- in 1 (7.14%) patients. In 3 patients after ventral «onlay» urethroplasty, after removal of the urethral catheter was noted suture failure. In these patients subsequently noted deformation of the urethra while preserving satisfactory urination. Urethroplasty using penile skin (by Orandi) held 9 patients. The length of the stricture from 15 to 65mm. No complications. All patients recovered adequate urination. Refused surgery for various reasons 8 patients.

IOU is necessary to consider palliative operation, resulting in only temporary improvement of the patients and is associated with significant complications and a high rate of recurrence. Wider application of modern techniques of plastic urethra, the use is not staged, and pathogenesis-based approach to the selection of the optimal method of treatment would greatly increase the effectiveness of the treatment of urethral stricture.