The meatal problem with TUR prostate: the value of post-operative self-dilatation.
In a preliminary retrospective study, we found that 37% of patients about to undergo a transurethral resection of the prostate had an external meatus too small to admit a 26 F resectoscope sheath. In a prospective study, a formal meatotomy was compared with an Otis urethrotomy for patients with a narrow meatus. This study was stopped because 71% of cases having a meatotomy developed strictures compared with 29% having an internal urethrotomy. In a further study of 59 patients, regular self-dilatation of the cut meatus with a plastic spigot was compared with internal urethrotomy of the meatus alone. Seven per cent of cases having self-dilatation developed strictures compared with 34% having internal urethrotomy. It was concluded that in those patients with a narrow external meatus meatotomy should not be carried out, but self-dilatation following internal urethrotomy greatly reduces the incidence of meatal strictures.
D004106:Dilatation / Q000295:instrumentation; D006801:Humans; D008297:Male; D008722:Methods; D011182:Postoperative Care; D011446:Prospective Studies; D011468:Prostatectomy / Q000009:adverse effects*; D011897:Random Allocation; D012189:Retrospective Studies; D012306:Risk; D012648:Self Care; D014521:Urethra / Q000601:surgery; D014525:Urethral Stricture / Q000209:etiology / Q000517:prevention & control*