Urethrotomy and Other Minimally Invasive Interventions for Urethral Stricture

Part of the Current Clinical Urology book series (CCU)


The minimally invasive interventions most often used for treating urethral strictures are dilation and direct vision internal urethrotomy (DVIU) which are equally effective for the initial treatment of strictures. The reported success rates with DVIU vary from 35 to 90 % and decline progressively with longer follow-up. The recurrence rates are higher with previously treated, long and multiple strictures, penile compared with bulbar strictures, and those with perioperative infection. Specific contraindications to DVIU include suspicion of urethral carcinoma, bleeding diathesis, and active infection.


  1. 1.
    Das S. Shusruta of India, the pioneer in the treatment of urethral stricture. Surg Gynecol Obstet. 1983;167:581–2.Google Scholar
  2. 2.
    Steenkamp JW, Heyns CF, De Kock ML. Internal urethrotomy versus dilation as treatment for male urethral strictures: a prospective, randomized comparison. J Urol. 1997;157:98–101.PubMedGoogle Scholar
  3. 3.
    Hjortrup A, Sorensen C, Sanders S, Moesgaard F, Kirkegaard P. Strictures of the male urethra treated by the Otis method. J Urol. 1983;130:903–4.PubMedGoogle Scholar
  4. 4.
    Schultheiss D, Truss MC, Jonas U. History of direct vision internal urethrotomy. Urology. 1998;52:729–34.PubMedGoogle Scholar
  5. 5.
    Lipsky H, Hubmer G. Direct vision urethrotomy in the management of urethral strictures. Br J Urol. 1977;49:725–8.PubMedGoogle Scholar
  6. 6.
    Keitzer WA, Cervantes L, Demaculangan A, Cruz B. Transurethral incision of bladder neck for contracture. J Urol. 1961;86:242–6.PubMedGoogle Scholar
  7. 7.
    Sandozi S, Ghazali S. Sachse optical urethrotomy, a modified technique: 6 years of experience. J Urol. 1988;140:968–9.PubMedGoogle Scholar
  8. 8.
    Blandy JP. Urethral stricture and carcinoma. In: Blandy J, editor. Urology, vol. 2. 1st ed. Oxford: Blackwell; 1976. p. 1014–48.Google Scholar
  9. 9.
    McCallum RW. Urethral disease and interventional cystourethrography. Radiol Clin North Am. 1986;24:651–62.PubMedGoogle Scholar
  10. 10.
    MacDiarmid SA, Harrigan CT, Cottone JL, McIntyre WJ, Johnson DE. Assessment of a new transurethral balloon dilation catheter in the treatment of urethral stricture disease. Urology. 2000;55:408–13.PubMedGoogle Scholar
  11. 11.
    Carter HB. Basic instrumentation and cystoscopy. In: Walsh PC, Retik AB, Darracott Vaughan E, Wein AJ, editors. Campbell’s urology, vol. 2. 8th ed. Philadelphia: Saunders; 2002. p. 114–6.Google Scholar
  12. 12.
    Jordan GH, Schlossberg SM. Surgery of the penis and urethra. In: Walsh PC, Retik AB, Darracott Vaughan E, Wein AJ, editors. Campbell’s urology, vol. 4. 8th ed. Philadelphia: Saunders; 2002. p. 3919–23.Google Scholar
  13. 13.
    Hare WS, McOmish D, Nunn IN. Percutaneous transvesical antegrade passage of urethral strictures. Urol Radiol. 1981;3:107–12.PubMedGoogle Scholar
  14. 14.
    Nishiyama T, Go H, Takashima A, Kawakami Y, Takeda M, Sato S. Balloon dilatation for entire urethral stricture. Urol Int. 1991;46:232–4.PubMedGoogle Scholar
  15. 15.
    Yildirim E, Cicek T, Istanbulluoglu O, Ozturk B. Use of cutting balloon in the treatment of urethral stricture: a novel technique. Cardiovasc Intervent Radiol. 2009;32:525–8.PubMedGoogle Scholar
  16. 16.
    Gelman J, Liss MA, Cinman NM. Direct vision balloon dilation for the management of urethral strictures. J Endourol. 2011;25:1249–51.PubMedGoogle Scholar
  17. 17.
    Dewan PA, Gotov E, Chiang D. Guide wire-assisted urethral dilatation for urethral strictures in pediatric urology. J Pediatr Surg. 2003;38:1790–2.PubMedGoogle Scholar
  18. 18.
    Herschorn S, Carrington E. S-shaped coaxial dilators for male urethral strictures. Urology. 2007;69:1199–201.PubMedGoogle Scholar
  19. 19.
    Hu Z, Ma X, Li HZ, Wang C, Ye DW, Gong DJ, Zhang X. A radially expanding sheath for urethral dilation. Med Hypotheses. 2009;73:585–6.PubMedGoogle Scholar
  20. 20.
    Athanasopoulos A, Liatsikos EN. The use of a ureteral access sheath for the urethral dilatation and catheterization of difficult urethral strictures. Urol Int. 2009;83:359–61.PubMedGoogle Scholar
  21. 21.
    Kinder PW, Rous SN. The treatment of urethral stricture disease by internal urethrotomy: a clinical review. J Urol. 1979;121:45–6.PubMedGoogle Scholar
  22. 22.
    Rossi Neto R, Tschirderwahn S, Rose A, vom Dorp F, Rübben H. Die endoskopische Behandlung der Harnröhrenstriktur [Endoscopic management of urethral stricture] [Article in German]. Urologe Ausg A. 2010;49:708, 710, 712–3.Google Scholar
  23. 23.
    Sachse H. Zur Behandlung der Harnröhrenstriktur: die transurethrale Schlitzung unter Sicht mit shcarfen Schnitt [On the treatment of urethral stricture: transurethral incision under vision using sharp section] [Article in German]. Fortschr Med. 1974;92:12–5.PubMedGoogle Scholar
  24. 24.
    Naudé AM, Heyns CF. What is the place of internal urethrotomy in the treatment of urethral stricture disease? Nat Clin Pract Urol. 2005;2:538–45.PubMedGoogle Scholar
  25. 25.
    Djulepa J, Potempa J. Urethrotomy technique in urethral strictures: 6-year results. J Urol. 1983;129:955–7.PubMedGoogle Scholar
  26. 26.
    Giannakopoulos X, Grammeniatis E, Gartzios A, Tsoumanis P, Kammenos A. Sachse urethrotomy versus endoscopic urethrotomy plus transurethral resection of the fibrous callus (Guillemin’s technique) in the treatment of urethral stricture. Urology. 1997;49:243–7.PubMedGoogle Scholar
  27. 27.
    Tomschi W, Suster G, Höltl W. Bladder neck strictures after radical retropubic prostatectomy: still an unsolved problem. Br J Urol. 1998;81:823–6.PubMedGoogle Scholar
  28. 28.
    Bülow H, Bülow U, Frohmüller HG. Transurethral laser urethrotomy in man: preliminary report. J Urol. 1979;121:286–7.PubMedGoogle Scholar
  29. 29.
    Geavlete P, Cauni V, Georgescu D. Value of preoperative urethral ultrasound in optic internal urethrotomy. Eur Urol. 2005;47:865–71.PubMedGoogle Scholar
  30. 30.
    Basok EK, Basaran A, Gurbuz C, Yildirim A, Tokuc R. Can bipolar vaporization be considered an alternative energy source in the endoscopic treatment of urethral strictures and bladder neck contracture? Int Braz J Urol. 2008;34:577–84; discussion 584–6.PubMedGoogle Scholar
  31. 31.
    Netto Jr NR, Lemos GC, Figueiredo JA. A comparative study of electrosurgical vs. cold urethrotomy in the treatment of urethral strictures. Int Urol Nephrol. 1979;11:311–5.PubMedGoogle Scholar
  32. 32.
    Gaches CG, Ashken MH, Dunn M, Hammonds JC, Jenkins IL, Smith PJ. The role of selective internal urethrotomy in the management of urethral stricture: a multi-centre evaluation. Br J Urol. 1979;51:579–83.PubMedGoogle Scholar
  33. 33.
    Tanagho EA, Lyon RP. Urethral dilatation versus internal urethrotomy. J Urol. 1971;105:242–4.PubMedGoogle Scholar
  34. 34.
    Pain JA, Collier DG. Factors influencing recurrence of urethral strictures after endoscopic urethrotomy: the role of infection and peri-operative antibiotics. Br J Urol. 1984;56:217–9.PubMedGoogle Scholar
  35. 35.
    Boccon-Gibod L, Le Portz B. Endoscopic urethrotomy: does it live up to its promises? J Urol. 1982;127:433–5.PubMedGoogle Scholar
  36. 36.
    Yurkanin JP, Dalkin BL, Cui H. Evaluation of cold knife urethrotomy for treatment of anastomotic stricture after radical retropubic prostatectomy. J Urol. 2001;165:1545–8.PubMedGoogle Scholar
  37. 37.
    Al-Ali M, Al-Shukry M. Endoscopic repair in 154 cases of urethral occlusion: the promise of guided optical urethral reconstruction. J Urol. 1997;157:129–31.PubMedGoogle Scholar
  38. 38.
    Gupta NP, Gill IS. Core-through optical internal urethrotomy in management of impassable traumatic posterior urethral strictures. J Urol. 1986;136:1018–21.PubMedGoogle Scholar
  39. 39.
    Matsuoka K, Inoue M, Iida S, Tomiyasu K, Noda S. Endoscopic antegrade laser incision in the treatment of urethral stricture. Urology. 2002;60:968–72.PubMedGoogle Scholar
  40. 40.
    Holm-Nielsen A, Schultz A, Moller-Pedersen V. Direct vision internal urethrotomy. A critical review of 365 operations. Br J Urol. 1984;56:308–12.PubMedGoogle Scholar
  41. 41.
    Netto Jr NR, Lemos GC, Claro JFA. Internal urethrotomy as a complementary method after urethroplasties for posterior urethral stenosis. J Urol. 1989;141:50–1.Google Scholar
  42. 42.
    Bødker A, Ostri P, Rye-Andersen J, Edvardsen L, Struckmann J. Treatment of recurrent urethral stricture by internal urethrotomy and intermittent self-catheterization: a controlled study of a new therapy. J Urol. 1992;148:308–10.PubMedGoogle Scholar
  43. 43.
    Albers P, Fichtner J, Brühl P, Müller SC. Long-term results of internal urethrotomy. J Urol. 1996;156:1611–4.PubMedGoogle Scholar
  44. 44.
    Pansadoro V, Emiliozzi P. Internal urethrotomy in the management of anterior urethral strictures: long-term followup. J Urol. 1996;156:73–5.PubMedGoogle Scholar
  45. 45.
    Ferguson GG, Bullock TL, Anderson RE, Blalock RE, Brandes SB. Minimally invasive methods for bulbar urethral strictures: a survey of members of the American Urological Association. Urology. 2011;78:701–6.PubMedGoogle Scholar
  46. 46.
    Chiou RK. Re: treatment of male urethral strictures: is repeated dilation or internal urethrotomy useful? J Urol. 1999;161:1583.PubMedGoogle Scholar
  47. 47.
    Kreder KJ, Stack R, Thrasher JB, Donatucci CF. Direct vision internal urethrotomy using topical anesthesia. Urology. 1993;42:548–50.PubMedGoogle Scholar
  48. 48.
    Ye G, Rong-Gui Z. Optical urethrotomy for anterior urethral stricture under a new local anesthesia: intracorpus spongiosum anesthesia. Urology. 2002;60:245–7.PubMedGoogle Scholar
  49. 49.
    Hsiao KC, Baez-Trinidad L, Lendvay T, Smith EA, Broecker B, Scherz H, Kirsch AJ. Direct vision internal urethrotomy for the treatment of pediatric urethral strictures: analysis of 50 patients. J Urol. 2003;170:952–5.PubMedGoogle Scholar
  50. 50.
    Dalkin BL. Endoscopic evaluation and treatment of anastomotic strictures after radical retropubic prostatectomy. J Urol. 1996;155:206–8.PubMedGoogle Scholar
  51. 51.
    Carr LK, Webster GD. Endoscopic management of the obliterated anastomosis following radical prostatectomy. J Urol. 1996;156:70–2.PubMedGoogle Scholar
  52. 52.
    Vaidyanathan S, Hughes PL, Singh G, Soni BM, Watt JW, Darroch J, Oo T. Location of urethral arteries by colour Doppler ultrasound. Spinal Cord. 2005;43:130–2.PubMedGoogle Scholar
  53. 53.
    McAninch JW, Laing FC, Jeffrey Jr RB. Sonourethrography in the evaluation of urethral strictures: a preliminary report. J Urol. 1988;139:294–7.PubMedGoogle Scholar
  54. 54.
    Merkle W, Wagner W. Sonography of the distal male urethra – a new diagnostic procedure for urethral strictures: results of a retrospective study. J Urol. 1988;140:1409–11.PubMedGoogle Scholar
  55. 55.
    Chiou RK, Donovan JM, Anderson JC, Matamoros Jr A, Wobig RK, Taylor RJ. Color Doppler ultrasound assessment of urethral artery location: potential implication for technique of visual internal urethrotomy. J Urol. 1998;159:796–9.PubMedGoogle Scholar
  56. 56.
    Kishore TA, Bhat S, John RP. Colour Doppler ultrasonographic location of the bulbourethral artery, and its impact on surgical outcome. BJU Int. 2005;96:624–8.PubMedGoogle Scholar
  57. 57.
    Turek PJ, Cendron M, Malloy TR, Carpiniello VL, Wein AJ. KTP-532 laser ablation of urethral strictures. Urology. 1992;40:330–4.PubMedGoogle Scholar
  58. 58.
    Becker HC, Miller J, Noske HD, Klask JP, Weidner W. Transurethral laser urethrotomy with argon-laser—experience with 900 urethrotomies in 450 patients from 1978 to 1993. Urol Int. 1995;55:150–3.PubMedGoogle Scholar
  59. 59.
    Kamal BA. The use of the diode laser for treating urethral strictures. BJU Int. 2001;87:831–3.PubMedGoogle Scholar
  60. 60.
    Gürdal M, Tekin A, Yücebaş E, Kireççi S, Sengör F. Contact neodymium: YAG laser ablation of recurrent urethral strictures using a side-firing fiber. J Endourol. 2003;17:791–4.PubMedGoogle Scholar
  61. 61.
    Futao S, Wentong Z, Yan Z, Qingyu D, Aiwu L. Application of endoscopic Ho:YAG laser incision technique treating urethral strictures and urethral atresias in pediatric patients. Pediatr Surg Int. 2006;22:514–8.PubMedGoogle Scholar
  62. 62.
    Hayashi T, Yoshinaga A, Ohno R, Ishii N, Watanabe T, Yamada T, Kihara K. Successful treatment of recurrent vesicourethral stricture after radical prostatectomy with holmium laser: report of three cases. Int J Urol. 2005;12:414–6.PubMedGoogle Scholar
  63. 63.
    Smith Jr JA. Treatment of benign urethral strictures using a sapphire tipped neodymium:YAG laser. J Urol. 1989;142:1221–2.PubMedGoogle Scholar
  64. 64.
    Adkins WC. Argon laser treatment of urethral stricture and vesical neck contracture. Lasers Surg Med. 1988;8:600–3.PubMedGoogle Scholar
  65. 65.
    Gonzalez R, Chiou RK, Hekmat K, Fraley EE. Endoscopic re-establishment of urethral continuity after traumatic disruption of the membranous urethra. J Urol. 1983;130:785–7.PubMedGoogle Scholar
  66. 66.
    Chiou RK, Gonzalez R. Endoscopic treatment of complete urethral obstruction using thin trocar. Urology. 1985;24:475–8.Google Scholar
  67. 67.
    Quint HJ, Stanisic TH. Above and below delayed endoscopic treatment of traumatic posterior urethral disruptions. J Urol. 1993;149:484–7.PubMedGoogle Scholar
  68. 68.
    Yilmaz U, Gunes A, Soylu A, Balbay MD. Evrim Bougie: a new instrument in the management of urethral strictures. BMC Urol. 2001;1:1.PubMedCentralPubMedGoogle Scholar
  69. 69.
    Chuang C-K, Lai M-K, Chu S-H. Optic internal urethrotomy under transrectal ultrasonographic guide and suprapubic fiberoscopic aid. J Urol. 1994;152:1435–7.PubMedGoogle Scholar
  70. 70.
    Dogra PN, Ansari MS, Gupta NP, Tandon S. Holmium laser core-through urethrotomy for traumatic obliterative strictures of urethra: initial experience. Urology. 2004;64:232–6.PubMedGoogle Scholar
  71. 71.
    Pettersson BA, Asklin B, Bratt C. Endourethral urethroplasty: a simple method of treatment of urethral strictures by internal urethrotomy and primary split skin grafting. Br J Urol. 1978;50:257–61.PubMedGoogle Scholar
  72. 72.
    Kamp S, Knoll T, Osman MM, Kohrmann KU, Michel MS, Alken P. Low-power holmium: YAG laser urethrotomy for treatment of urethral strictures: functional outcome and quality of life. J Endourol. 2006;20:38–41.PubMedGoogle Scholar
  73. 73.
    Chiou RK. Endourethroplasty in the management of complicated posterior urethral stricture. J Urol. 1988;140:607–10.PubMedGoogle Scholar
  74. 74.
    Naudé JH. Endoscopic skin-graft urethroplasty. World J Urol. 1998;16:171–4.PubMedGoogle Scholar
  75. 75.
    Heyns CF, Steenkamp JW, De Kock ML, Whitaker P. Treatment of male urethral strictures: is repeated dilation or internal urethrotomy useful? J Urol. 1998;160:356–8.PubMedGoogle Scholar
  76. 76.
    Greenland JE, Lynch TH, Wallace DM. Optical urethrotomy under local urethral anaesthesia. Br J Urol. 1991;67:385–8.PubMedGoogle Scholar
  77. 77.
    Steenkamp JW, Heyns CF, de Kock ML. Outpatient treatment for male urethral strictures – dilatation versus internal urethrotomy. S Afr J Surg. 1997;35:125–30.PubMedGoogle Scholar
  78. 78.
    Ogbonna BC. Managing many patients with a urethral stricture: a cost-benefit analysis of treatment options. Br J Urol. 1998;81:741–4.PubMedGoogle Scholar
  79. 79.
    Munks DG, Alli MO, Goad EH. Optical urethrotomy under local anaesthesia is a feasible option in urethral stricture disease. Trop Doct. 2010;40:31–2.PubMedGoogle Scholar
  80. 80.
    Ather MH, Zehri AA, Soomro K, Nazir I. The safety and efficacy of optical urethrotomy using a spongiosum block with sedation: a comparative nonrandomized study. J Urol. 2009;181:2134–8.PubMedGoogle Scholar
  81. 81.
    Al-Hunayan A, Al-Awadi K, Al-Khayyat A, Abdulhalim H. A pilot study of transperineal urethrosphincteric block for visual internal urethrotomy in patients with anterior urethral strictures. J Endourol. 2008;22:1017–20.PubMedGoogle Scholar
  82. 82.
    Fourcade RO, Mathieu F, Chatelain C, Jardin A, Richard F, Kuss R. Endoscopic internal urethrotomy for treatment of urethral strictures: midterm survey. Urology. 1981;18:33–6.PubMedGoogle Scholar
  83. 83.
    Murdoch DA, Badenoch DF. Oral ciprofloxacin as prophylaxis for optical urethrotomy. Br J Urol. 1987;60:352–4.PubMedGoogle Scholar
  84. 84.
    Tunc M, Tefekli A, Kadioglu A, Esen T, Uluocak N, Aras N. A prospective, randomized protocol to examine the efficacy of postinternal urethrotomy dilations for recurrent bulbomembranous urethral strictures. Urology. 2002;60:239–44.PubMedGoogle Scholar
  85. 85.
    Zambon JV, Delaere KPJ. Prevention of recurrent urethral strictures by intermittent low-friction self-catheterisation. Eur Urol. 1990;18 Suppl 1:277; abstract 535.Google Scholar
  86. 86.
    Heyns CF, Marais DC. Prospective evaluation of the American Urological Association symptom index and peak urinary flow rate for the followup of men with known urethral stricture disease. J Urol. 2002;168:2051–4.PubMedGoogle Scholar
  87. 87.
    Carlton FE, Scardino PL, Quattlebaum RB. Treatment of urethral strictures with internal urethrotomy and 6 weeks of silastic catheter drainage. J Urol. 1974;111:191–3.PubMedGoogle Scholar
  88. 88.
    Hossain AZ, Khan SA, Hossain S, Salam MA. Holmium laser urethrotomy for urethral stricture. Bangladesh Med Res Counc Bull. 2004;30:78–80.PubMedGoogle Scholar
  89. 89.
    Iversen Hansen R, Guldberg O, Moller I. Internal urethrotomy with the Sachse urethrotome. Scand J Urol Nephrol. 1981;15:189–91.PubMedGoogle Scholar
  90. 90.
    van Leeuwen MA, Brandenburg JJ, Kok ET, Vijverberg PL, Bosch JL. Management of adult anterior urethral stricture disease: nationwide survey among urologists in the Netherlands. Eur Urol. 2011;60:159–66.PubMedGoogle Scholar
  91. 91.
    Hammarsten J, Lindqvist K, Sunzel H. Urethral strictures following transurethral resection of the prostate. The role of the catheter. Br J Urol. 1989;63:397–400.PubMedGoogle Scholar
  92. 92.
    Stormont TJ, Suman VJ, Oesterling JE. Newly diagnosed bulbar urethral strictures: etiology and outcome of various treatments. J Urol. 1993;150:1725–8.PubMedGoogle Scholar
  93. 93.
    Graversen PH, Rosenkilde P, Colstrup H. Erectile dysfunction following direct vision internal urethrotomy. Scand J Urol Nephrol. 1991;25:175–8.PubMedGoogle Scholar
  94. 94.
    Schneider T, Sperling H, Lummen G, Rubben H. Sachse internal urethrotomy. Is erectile dysfunction a possible complication? Article in German. Urologe A. 2001;40:38–41.PubMedGoogle Scholar
  95. 95.
    Chen GL, Berger RE. Treatment of impotence resulting from internal urethrotomy. J Urol. 1997;158:542.PubMedGoogle Scholar
  96. 96.
    Bapuraj JR, Sridhar S, Sharma SK, Suri S. Endovascular treatment of a distal urethral-internal pudendal artery fistula complicating internal optical urethrotomy of a post-traumatic urethral stricture. BJU Int. 1999;83:353–4.PubMedGoogle Scholar
  97. 97.
    Karagiannis AA, Sopilidis OT, Brountzos EN, Staios DN, Kelekis NL, Kelekis DA. High flow priapism secondary to internal urethrotomy treated with embolization. J Urol. 2004;171:1631–2.PubMedGoogle Scholar
  98. 98.
    De la Rosette JJ, de Vries JD, Lock MT, Debruyne FM. Urethroplasty using the pedicled island flap technique in complicated urethral strictures. J Urol. 1991;146:40–2.PubMedGoogle Scholar
  99. 99.
    Roehrborn CG, McConnell JD. Analysis of factors contributing to success or failure of 1-stage urethroplasty for urethral stricture disease. J Urol. 1994;151:869–74.PubMedGoogle Scholar
  100. 100.
    Martinez-Pineiro JA, Carcamo P, Garcia Matres MJ, Martinez-Pineiro L, Iglesias JR, Rodriguez Ledesma JM. Excision and anastomotic repair for urethral stricture disease: experience with 150 cases. Eur Urol. 1997;32:433–41.PubMedGoogle Scholar
  101. 101.
    Barbagli G, Palminteri E, Lazzeri M, Guazzoni G, Turini D. Long-term outcome of urethroplasty after failed urethrotomy versus primary repair. J Urol. 2001;165:1918–9.Google Scholar
  102. 102.
    Barbagli G, Palminteri E, Guazzoni G, Montorsi F, Turini D, Lazzeri M. Bulbar urethroplasty using buccal mucosa grafts placed on the ventral, dorsal or lateral surface of the urethra: are results affected by the surgical technique? J Urol. 2005;174:955–8.PubMedGoogle Scholar
  103. 103.
    Andrich DE, Dunglison N, Greenwell TJ, Mundy AR. The long-term results of urethroplasty. J Urol. 2003;170:90–2.PubMedGoogle Scholar
  104. 104.
    Park SP, McAninch JW. Straddle injuries to the bulbar urethra: management and outcomes in 78 patients. J Urol. 2004;171:722–5.Google Scholar
  105. 105.
    Fenton AS, Morey AF, Aviles R, Garcia CR. Anterior urethral strictures: etiology and characteristics. Urology. 2005;65:1055–8.PubMedGoogle Scholar
  106. 106.
    Culty T, Boccon-Gibod L. Anastomotic urethroplasty for posttraumatic urethral stricture: previous urethral manipulation has a negative impact on the final outcome. J Urol. 2007;177:1374–7.PubMedGoogle Scholar
  107. 107.
    Lumen N, Hoebeke P, Troyer BD, Ysebaert B, Oosterlinck W. Perineal anastomotic urethroplasty for posttraumatic urethral stricture with or without previous urethral manipulations: a review of 61 cases with long-term followup. J Urol. 2009;181:1196–200.PubMedGoogle Scholar
  108. 108.
    Singh BP, Andankar MG, Swain SK, Das K, Dassi V, Kaswan HK, Agrawal V, Pathak HR. Impact of prior urethral manipulation on outcome of anastomotic urethroplasty for post-traumatic urethral stricture. Urology. 2010;75:179–82.PubMedGoogle Scholar
  109. 109.
    Gary R, Cass AS, Koos G. Vascular complications of transurethral incision of post-traumatic urethral strictures. J Urol. 1988;140:1539–40.PubMedGoogle Scholar
  110. 110.
    Duel BP, Barthold JS, Gonzalez R. Management of urethral strictures after hypospadias repair. J Urol. 1998;160:170–1.PubMedGoogle Scholar
  111. 111.
    Merkle W, Wagner W. Risk of recurrent stricture following internal urethrotomy. Prospective ultrasound study of distal male urethra. Br J Urol. 1990;65:618–20.PubMedGoogle Scholar
  112. 112.
    Pitkämäki KK, Tammela TL, Kontturi MJ. Recurrence of urethral stricture and late results after optical urethrotomy: comparison of strictures caused by toxic latex catheters and other causes. Scand J Urol Nephrol. 1992;26:327–31.PubMedGoogle Scholar
  113. 113.
    Desmond AD, Evans CM, Jameson RM, Woolfenden KA, Gibbon NO. Critical evaluation of direct vision urethrotomy by urine flow measurement. Br J Urol. 1981;53:630–3.PubMedGoogle Scholar
  114. 114.
    Gargollo PC, Cai AW, Borer JG, Retik AB. Management of recurrent urethral strictures after hypospadias repair: is there a role for repeat dilation or endoscopic incision? J Pediatr Urol. 2011;7:34–8.PubMedGoogle Scholar
  115. 115.
    Ishigooka M, Tomaru M, Hashimoto T, Sasagawa I, Nakada T, Mitobe K. Recurrence of urethral stricture after single internal urethrotomy. Int Urol Nephrol. 1995;27:101–6.PubMedGoogle Scholar
  116. 116.
    Zehri AA, Ather MH, Afshan Q. Predictors of recurrence of urethral stricture disease following optical urethrotomy. Int J Surg. 2009;7:361–4.PubMedGoogle Scholar
  117. 117.
    Koraitim M. Experience with 170 cases of posterior urethral strictures during 7 years. J Urol. 1985;133:408–10.PubMedGoogle Scholar
  118. 118.
    Stone AR, Randall JR, Shorrock K, Peeling WB, Rose MB, Stephenson TP. Optical urethrotomy – a 3-year experience. Br J Urol. 1983;55:701–4.PubMedGoogle Scholar
  119. 119.
    Santucci R, Eisenberg L. Urethrotomy has a much lower success rate than previously reported. J Urol. 2010;183:1859–62.PubMedGoogle Scholar
  120. 120.
    Anger JT, Scott VC, Sevilla C, Wang M, Yano EM. Patterns of management of urethral stricture disease in the Veterans Affairs system. Urology. 2011;78:454–8.PubMedGoogle Scholar
  121. 121.
    Jabłonowski Z, Kedzierski R, Miekoś E, Sosnowski M. Comparison of neodymium-doped yttrium aluminum garnet laser treatment with cold knife endoscopic incision of urethral strictures in male patients. Photomed Laser Surg. 2010;28:239–44.PubMedGoogle Scholar
  122. 122.
    Atak M, Tokgöz H, Akduman B, Erol B, Dönmez I, Hancı V, Türksoy O, Mungan NA. Low-power holmium:YAG laser urethrotomy for urethral stricture disease: comparison of outcomes with the cold-knife technique. Kaohsiung J Med Sci. 2011;27:503–7.PubMedGoogle Scholar
  123. 123.
    Jin T, Li H, Jiang LH, Wang L, Wang KJ. Safety and efficacy of laser and cold knife urethrotomy for urethral stricture. Chin Med J (Engl). 2010;123:1589–95.Google Scholar
  124. 124.
    Koraitim MM. Post-traumatic posterior urethral strictures: preoperative decision making. Urology. 2004;64:228–31.PubMedGoogle Scholar
  125. 125.
    Levine J, Wessells H. Comparison of open and endoscopic treatment of posttraumatic posterior urethral strictures. World J Surg. 2001;25:1597–601.PubMedGoogle Scholar
  126. 126.
    Le Roux PJ. Endoscopic urethroplasty with unseeded small intestinal submucosa collagen matrix grafts: a pilot study. J Urol. 2005;173:140–3.PubMedGoogle Scholar
  127. 127.
    Kuyumcuoglu U, Eryildirim B, Tarhan F, Faydaci G, Ozgül A, Erbay E. Antegrade endourethroplasty with free skin graft for recurrent vesicourethral anastomotic strictures after radical prostatectomy. J Endourol. 2010;24:63–7.PubMedGoogle Scholar
  128. 128.
    Farahat YA, Elbahnasy AM, El-Gamal OM, Ramadan AR, El-Abd SA, Taha MR. Endoscopic urethroplasty using small intestinal submucosal patch in cases of recurrent urethral stricture: a preliminary study. J Endourol. 2009;23:2001–5.PubMedGoogle Scholar
  129. 129.
    Newman LH, Stone NN, Chircus JH, Kramer HC. Recurrent urethral stricture disease managed by clean intermittent self-catheterization. J Urol. 1990;144:1142–3.PubMedGoogle Scholar
  130. 130.
    Kjaergaard B, Walter S, Bartholin J, Andersen JT, Nahr S, Beck H, Jensen BN, Lokdam A, Glavind K. Prevention of urethral stricture recurrence using clean intermittent self-catheterization. Br J Urol. 1994;73:692–5.PubMedGoogle Scholar
  131. 131.
    Mandhani A, Chaudhury H, Kapoor R, Srivastava A, Dubey D, Kumar A. Can outcome of internal urethrotomy for short segment bulbar urethral stricture be predicted? J Urol. 2005;173:1595–7.PubMedGoogle Scholar
  132. 132.
    Andronaco RB, Warner RS, Cohen MS. Optical urethrotomy as ambulatory procedure. Urology. 1984;24:268–70.PubMedGoogle Scholar
  133. 133.
    Hafez AT, El Assmy A, Dawaba MS, Sarhan O, Bazeed M. Long-term outcome of visual internal urethrotomy for the management of pediatric urethral strictures. J Urol. 2005;173:595–7.PubMedGoogle Scholar
  134. 134.
    Shawky E. Endoscopic treatment of post-traumatic urethral obliteration: experience in 396 patients. J Urol. 1995;153:67–71.Google Scholar
  135. 135.
    Kaisary AV. Postoperative care following internal urethrotomy. Urology. 1985;26:333–6.PubMedGoogle Scholar
  136. 136.
    Dahl C, Hansen RI. Optical internal urethrotomy with and without catheter. A comparative study. Ann Chir Gynaecol. 1986;75:283–4.PubMedGoogle Scholar
  137. 137.
    Asklin B, Nilsson A, Pettersson S. Functional evaluation of anterior urethral strictures with combined antegrade and retrograde urethrography. Scand J Urol Nephrol. 1984;18:1–7.PubMedGoogle Scholar
  138. 138.
    Lawrence WT, MacDonagh RP. Treatment of urethral stricture disease by internal urethrotomy followed by intermittent “low-friction” self-catheterization: preliminary communication. J R Soc Med. 1988;81:136–9.PubMedCentralPubMedGoogle Scholar
  139. 139.
    Harriss DR, Beckingham IJ, Lemberger RJ, Lawrence WT. Long-term results of intermittent low-friction self-catheterization in patients with recurrent urethral strictures. Br J Urol. 1994;74:790–2.PubMedGoogle Scholar
  140. 140.
    Gnanaraj J, Devasia A, Gnanaraj L, Pandey AP. Intermittent self catheterization versus regular outpatient dilatation in urethral stricture: a comparison. Aust N Z J Surg. 1999;69:41–3.PubMedGoogle Scholar
  141. 141.
    Lin YH, Huang WJ, Chen KK. Using stainless steel chopstick for self-performing urethral sounding in preventing recurrence of anterior urethral stricture. J Chin Med Assoc. 2006;69:189–92.PubMedGoogle Scholar
  142. 142.
    Lauritzen M, Greis G, Sandberg A, Wedren H, Ojdeby G, Henningsohn L. Intermittent self-dilatation after internal urethrotomy for primary urethral strictures: a case-control study. Scand J Urol Nephrol. 2009;43:220–5.PubMedGoogle Scholar
  143. 143.
    Ngugi PM, Kassim A. Clean intermittent catheterisation in the management of urethral strictures. East Afr Med J. 2007;84:522–4.PubMedGoogle Scholar
  144. 144.
    Roosen JU. Self-catheterization after urethrotomy. Prevention of urethral stricture recurrence using clean intermittent self-catheterization. Urol Int. 1993;50:90–2.PubMedGoogle Scholar
  145. 145.
    Rijal A, Little B, McPhee S, Meddings RN. Intermittent self dilatation – still a viable option for treatment of urethral stricture disease. Nepal Med Coll J. 2008;10:155–9.PubMedGoogle Scholar
  146. 146.
    Morey A. Urethral stricture is now an open surgical disease. J Urol. 2009;181:953–4.PubMedGoogle Scholar
  147. 147.
    Levine LA, Engebrecht BP. Adjuvant home urethral balloon dilation for the recalcitrant urethral stricture. J Urol. 1997;158(3 Pt 1):818–21.PubMedGoogle Scholar
  148. 148.
    Morgia G, Saita A, Falsaperla M, Spampinato A, Motta M, Cordaro S. Immunohistochemical and molecular analysis in recurrent urethral stricture. Urol Res. 2000;28:319–22.PubMedGoogle Scholar
  149. 149.
    Singh M, Blandy JP. The pathology of urethral stricture. J Urol. 1976;115:673–6.PubMedGoogle Scholar
  150. 150.
    Da-Silva EA, Sampaio FJ, Dornas MC, Damiao R, Cardoso LE. Extracellular matrix changes in urethral stricture disease. J Urol. 2002;168:805–7.PubMedGoogle Scholar
  151. 151.
    Cavalcanti AG, Costa WS, Baskin LS, McAninch JA, Sampaio FJ. A morphometric analysis of bulbar urethral strictures. BJU Int. 2007;100:397–402.PubMedGoogle Scholar
  152. 152.
    Hebert PW. The treatment of urethral stricture: transurethral injection of triamcinolone: a preliminary report. J Urol. 1971;105:403–6.PubMedGoogle Scholar
  153. 153.
    Hosseini J, Kaviani A, Golshan AR. Clean intermittent catheterization with triamcinolone ointment following internal urethrotomy. Urol J. 2008;5:265–8.PubMedGoogle Scholar
  154. 154.
    Mazdak H, Izadpanahi MH, Ghalamkari A, Kabiri M, Khorrami MH, Nouri-Mahdavi K, Alizadeh F, Zargham M, Tadayyon F, Mohammadi A, Yazdani M. Internal urethrotomy and intraurethral submucosal injection of triamcinolone in short bulbar urethral strictures. Int Urol Nephrol. 2009;42:565–8.PubMedGoogle Scholar
  155. 155.
    Gücük A, Tuygun C, Burgu B, Oztürk U, Dede O, Imamoğlu A. The short-term efficacy of dilatation therapy combined with steroid after internal urethrotomy in the management of urethral stenoses. J Endourol. 2010;24:1017–21.PubMedGoogle Scholar
  156. 156.
    Tavakkoli Tabassi K, Yarmohamadi A, Mohammadi S. Triamcinolone injection following internal urethrotomy for treatment of urethral stricture. Urol J. 2011;8:132–6.PubMedGoogle Scholar
  157. 157.
    Sciarra A, Salciccia S, Albanesi L, Cardi A, D’Eramo G, Di Silverio F. Use of cyclooxygenase-2 inhibitor for prevention of urethral strictures secondary to transurethral resection of the prostate. Urology. 2005;66:1218–22.PubMedGoogle Scholar
  158. 158.
    Nagler A, Gofrit O, Ohana M, Pode D, Genina O, Pines M. The effect of halofuginone, an inhibitor of collagen type i synthesis, on urethral stricture formation: in vivo and in vitro study in a rat model. J Urol. 2000;164(5):1776–80.PubMedGoogle Scholar
  159. 159.
    Jaidane M, Ali-El-Dein B, Ounaies A, Hafez AT, Mohsen T, Bazeed M. The use of halofuginone in limiting urethral stricture formation and recurrence: an experimental study in rabbits. J Urol. 2003;170:2049–52.PubMedGoogle Scholar
  160. 160.
    Krane LS, Gorbachinsky I, Sirintrapun J, Yoo JJ, Atala A, Hodges SJ. Halofuginone-coated urethral catheters prevent periurethral spongiofibrosis in a rat model of urethral injury. J Endourol. 2011;25:107–12.PubMedGoogle Scholar
  161. 161.
    Khera M, Boone TB, Smith CP. Botulinum toxin type A: a novel approach to the treatment of recurrent urethral strictures. J Urol. 2004;172:574–5.PubMedGoogle Scholar
  162. 162.
    Ayyildiz A, Nuhoglu B, Gulerkaya B, Caydere M, Ustun H, Germiyanoglu C, Erol D. Effect of intraurethral Mitomycin-C on healing and fibrosis in rats with experimentally induced urethral stricture. Int J Urol. 2004;11:1122–6.PubMedGoogle Scholar
  163. 163.
    Mazdak H, Meshki I, Ghassami F. Effect of mitomycin C on anterior urethral stricture recurrence after internal urethrotomy. Eur Urol. 2007;51:1089–92.PubMedGoogle Scholar
  164. 164.
    Shirazi M, Khezri A, Samani SM, Monabbati A, Kojoori J, Hassanpour A. Effect of intraurethral captopril gel on the recurrence of urethral stricture after direct vision internal urethrotomy: phase II clinical trial. Int J Urol. 2007;14:203–8.PubMedGoogle Scholar
  165. 165.
    Chong T, Fu DL, Li HC, Zhang HB, Zhang P, Gan WM, Wang ZM. Rapamycin inhibits formation of urethral stricture in rabbits. J Pharmacol Exp Ther. 2011;338:47–52.PubMedGoogle Scholar
  166. 166.
    Kim HM, Kang DI, Shim BS, Min KS. Early experience with hyaluronic acid instillation to assist with visual internal urethrotomy for urethral stricture. Korean J Urol. 2010;51:853–7.PubMedCentralPubMedGoogle Scholar
  167. 167.
    Sun YH, Xu CL, Gao X, Jin YN, Wang LH, Liao GQ, Wang ZF, Hou JG, Qian SX, Yong-Jiang MA. Intraurethral brachytherapy for prevention of recurrent urethral stricture after internal urethrotomy or transurethral resection of scar. J Endourol. 2001;15:859–61.PubMedGoogle Scholar
  168. 168.
    Olschewski T, Kropfl D, Seegenschmiedt MH. Endourethral brachytherapy for prevention of recurrent urethral stricture following internal urethrotomy-first clinical experiences and results. Int J Radiat Oncol Biol Phys. 2003;57:1400–4.PubMedGoogle Scholar
  169. 169.
    Shin JH, Song HY, Moon DH, Oh SJ, Kim TH, Lim JO. Rhenium-188 mercaptoacetyltriglycine-filled balloon dilation in the treatment of recurrent urethral strictures: initial experience with five patients. J Vasc Interv Radiol. 2006;17:1471–7.PubMedGoogle Scholar
  170. 170.
    Guan Y, Ou L, Hu G, Wang H, Xu Y, Chen J, Zhang J, Yu Y, Kong D. Tissue engineering of urethra using human vascular endothelial growth factor gene-modified bladder urothelial cells. Artif Organs. 2008;32:91–9.PubMedGoogle Scholar
  171. 171.
    Bullock TL, Brandes SB. Adult anterior urethral strictures: a national practice patterns survey of board certified urologists in the United States. J Urol. 2007;177:685–90.PubMedGoogle Scholar
  172. 172.
    Emmett JL, Rous SN, Greene LF, De Weerd JH, Utz DC. Preliminary internal urethrotomy in 1036 cases to prevent urethral stricture following transurethral resection; caliber of normal adult male urethra. J Urol. 1963;89(6):829–35.Google Scholar
  173. 173.
    Bailey MJ, Shearer RJ. The role of internal urethrotomy in the prevention of urethral stricture following transurethral resection of the prostate. Br J Urol. 1979;51:28–31.PubMedGoogle Scholar
  174. 174.
    Schultz A, Bay-Nielsen H, Bilde T, Christiansen L, Mikkelsen AM, Steven K. Prevention of urethral stricture formation after transurethral resection of the prostate: a controlled randomized study of Otis urethrotomy versus urethral dilation and the use of the polytetrafluoroethylene coated versus the uninsulated metal sheath. J Urol. 1989;141:73–5.PubMedGoogle Scholar
  175. 175.
    Kumar P, Nargund VH. Management of post-radical prostatectomy anastomotic stricture by endoscopic transurethral balloon dilatation. Scand J Urol Nephrol. 2007;41:314–5.PubMedGoogle Scholar
  176. 176.
    Lagerveld BW, Laguna MP, Debruyne FM, De La Rosette JJ. Holmium:YAG laser for treatment of strictures of vesicourethral anastomosis after radical prostatectomy. J Endourol. 2005;19:497–501.PubMedGoogle Scholar
  177. 177.
    Merrick GS, Butler WM, Wallner KE, Galbreath RW, Anderson RL, Allen ZA, Adamovich E. Risk factors for the development of prostate brachytherapy related urethral strictures. J Urol. 2006;175:1376–80.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  1. 1.Department of UrologyStellenbosch Universiteit en Tygerberg-HospitalTygerberg, Cape TownSouth Africa

Personalised recommendations