title: Initial experience of transurethral resection with pediatric resectoscope for incomplete anterior urethral stricture.
abstract: OBJECTIVE
  Endoscopic urethrotomy is an alternative method in treatment of urethral stricture. However, it have high recurrence rate because of the remained fibrotic tissue. Removal of the fibrotic tissue can maintain the patency of the urethral lumen after the procedure. We report the therapeutic efficacy of our initial experience using pediatric resectoscope for treating anterior urethral stricture in 16 cases.
  
  
  METHODS
  From January 2009 to April 2011, transurethral resection with pediatric resectoscope was primarily performed on 16 patients with anterior urethral stricture. Retrograde urethrography, uroflowmetry, postvoid residual volume, IPSS score and QoL score were performed preoperatively. We used 11.5Fr pediatric resectoscope (Wolf) and monopolar electrosurgical generator. The stricture was incised under vision at the 12 o'clock location or the site of maximum scar tissue or narrowing in asymmetric strictures for working space. After incision, transurethral resection with pediatric resectoscope was performed to all scar tissues. Monopolar cutting current was set on 45 watt and coagulation current was set on 30 watt, fulgurate mode. Postoperatively, drainage of the bladder was performed for 7 days using an 18F latex catheter. Patients were followed up by IPSS score, QoL score, uroflowmetry and postvoid residual volume.
  
  
  RESULTS
  Successful results without recurrence were achieved in 11 of 16 patients. Postoperative urethral dilation had been performed average 2.4 times (0~6 times). When we classified the results by etiology, the number of successful results in strictures with a trauma, iatrogenic, or unknown cause was 5 (7/11), 3 (3/4) and 1 (1/1), respectively. In 5 patients who failed treatment, we repeated transurethral resection with pediatric resectoscope in 1 patient, and periodic urethral dilation in 4 patients. No operative complications occurred in any patients.
  
  
  CONCLUSIONS
  Transurethral resection with pediatric resectoscope is an effective therapeutic method for anterior urethral stricture. More long-term follow-up and large scale studies are needed to confirm the efficacy of this procedure.
authors.affiliation: Department of Urology, Chonnam National University Medical School, Gwangju, Korea.
authors.forename: Won Seok
authors.initials: WS
authors.lastname: Jang
authors.forename: Se Heon
authors.initials: SH
authors.lastname: Jeong
authors.forename: Ho Song
authors.initials: HS
authors.lastname: Yu
authors.forename: In Sang
authors.initials: IS
authors.lastname: Hwang
authors.forename: Eu Chang
authors.initials: EC
authors.lastname: Hwang
authors.forename: Sun-Ouck
authors.initials: SO
authors.lastname: Kim
authors.forename: Kyung Jin
authors.initials: KJ
authors.lastname: Oh
authors.forename: Seung Ii
authors.initials: SI
authors.lastname: Jung
authors.forename: Dong Deuk
authors.initials: DD
authors.lastname: Kwon
authors.forename: Kwangsung
authors.initials: K
authors.lastname: Park
authors.forename: Taek Won
authors.initials: TW
authors.lastname: Kang
mesh_terms: D000328:Adult; D000368:Aged; D004724:Endoscopy / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D016896:Treatment Outcome; D014521:Urethra / Q000601:surgery*; D014525:Urethral Stricture / Q000601:surgery*