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Long-term effect of urethral dilatation and internal urethrotomy for urethral strictures

Veeratterapillay, Rajana; Pickard, Rob S.a,b

doi: 10.1097/MOU.0b013e32835621a2
URETHRAL RECONSTRUCTION: Edited by Margit Fisch
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Purpose of review Urethral dilatation and direct visual internal urethrotomy (DVIU) are widely used minimally invasive options to manage men with urethral strictures. Advances in open urethroplasty with better long-term cure rates have fuelled the continuing debate as to which treatment is best for primary and recurrent urethral strictures. We reviewed recent literature to identify contemporary practice of urethral dilatation and DVIU and the long-term outcome of these procedures.

Recent findings Systematic literature search for the period January 2010 to December 2011 showed that urethral dilatation and DVIU remain frequently used treatment options as confirmed by surveys of urologists in the USA and the Netherlands. Multiple reports of laser DVIU confirm the safety of this approach but long-term data were lacking. Stricture free rates from urethra dilatation and DVIU vary from 10 to 90% at 12 months, although adjunctive intermittent self-dilatation can reduce time to recurrence. Although quality-of-life benefit appears good in the short term, repeated procedures may harm sexual function in the long-term.

Summary Urethral dilatation and DVIU remain widely used in urethral stricture management but high-level comparative evidence of benefit and harms against urethroplasty in the short and long-term is still lacking.

aDepartment of Urology, Newcastle upon Tyne Hospitals NHS Foundation Trust

bInstitute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK

Correspondence to Mr Rajan Veeratterapillay, MBBS MRCS (Eng), Specialist Registrar, Department of Urology, Freeman Hospital, Newcastle upon Tyne, NE7 7DN, UK. Tel: +44 191 213 7139; fax: +44 191 213 7127; e-mail: veeratterapillayr@doctors.org.uk

© 2012 Lippincott Williams & Wilkins, Inc.