[Antegrade-retrograde urethrotomy in therapy of high degree urethral stricture].
In the case of urethral stricture which is non-passable by conventional "cold knife" urethrotomy, open urethroplasty can be avoided by combined antegrade-retrograde urethrotomy (ARUT). A rigid cystoscope is guided, through a dilated, suprapubic cystostomy channel, to the stricture in the membranous or bulbular urethra. A urethrotome is inserted in the retrograde direction and the "cut to the light" procedure is adopted. Using the ARUT method, successful realignment was achieved in 9 patients; 4 strictures were trauma- or urethritis-induced and 5 were the result of transurethral management. Recurrent stricture in 4 out of 7 cases (57%) required further urethrotomy. There was no recurrence in 4 out of 7 patients for at least 5 months subsequent to the last treatment. All patients were spared open surgery. The antegrade-retrograde technique exists since 1978. Up to date, 63 cases have been mentioned in the literature. The primary therapy success rate is 25%. Successful retreatment following recurrence was observed in 65%. We recommend ARUT as first-choice treatment for severe strictures of the bulbular and membranous urethra.
Köhrmann
K U
KU
Urologische Klinik, Fakultät für klinische Medizin Mannheim, Universität Heidelberg.
Schmidt
P
P
Potempa
D
D
Löbelenz
M
M
Rassweiler
J
J
Alken
P
P
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D014521:Urethra / Q000293:injuries / Q000601:surgery; D014525:Urethral Stricture / Q000209:etiology / Q000601:surgery*; D014563:Urodynamics / Q000502:physiology
Die antegrad-retrograde Urethrotomie zur Therapie von hochgradigen Harnröhrenstrikturen.