📃 Paper Title: Internal Urethrotomy in the Management of Anterior Urethral Strictures: Long-Term Followup
🧍 Author: Pansadoro
🕒 Year: 1996
📚 Journal: Journal of Urology
🌎 Country: Italy
ㅤContext to the study:
Can you tell me about a study that reported the recurrence after urethrotomy for anterior strictures?
ㅤ✅ Take-home message of study:
Recurrence rate after 1 urethrotomy 68% overall
58% bulbar
84% penile
89% penile bulbar
Repeated urethrotomies do not improve success rates (regardless of aetiology), therefore recurrence after initial urethrotomy should prompt consideration of alternative treatments.
Improved prognosis in:
single or primary strictures,
stricture length <10mm,
width caliber >15Fr
ㅤ Retrospective case series
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Study participants:
450 Patients between 1975 and 1990 undergoing cold knife urethrotomy evaluated, 224 included.
Median age 62 (11-98 range), median stricture length 16mm
Median follow up: 98 months (range 60-216)
Uroflow monthly for 3/12, 3/12ly for 9/12, 6/12ly during year 2, then annually.
When peak flow <15ml/s cystourethrography performed.
Aetiology:
Iatrogenic (40%) infective (29%) traumatic (4%) congenital (2%) unknown (25%)
Preoperative assessment including retrograde and voiding cystourethrography, uroflowmetry and urine culture.
Excluded: follow up <60 months and preoperative Qmax >15ml/s
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Key study outcomes:
Success = 32% Overall
42% bulbar
Success 71% if stricture <10mm length, 18% if >10mm
success 69% of stricture >15Fr calibre, 34% if <15Fr
16% penile
**11% penile bulbar **
no correlation between calibre and length in penile or penile bulbar strictures success rate.
The third urethrotomy failed in all patients
56% of recurrence occurred within 12 months
26% occurred between 12 and 24 months
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Study Limitations:
Retrospective review
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