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Urethral stricture, the current role of urethroplasty. Literature review
Urethral stricture, the current role of urethroplasty. Literature review
Jorge A. Ruiz-Ortuño 1, Eloy Rico-Frontana 2, Alejandro Madero-Arteaga 3, Yunuen Rodríguez-Sánchez 4, David Vargas-Villarreal 5
1 Servicio de Urología, Hospital Regional de Alta Especialidad Centenario de la Revolución Mexicana, Instituto de Seguridad y Servicios Sociales para los Trabajadores del Estado, Emiliano Zapata, Mor., México; 2 Servicio de Urología, Hospital General Dr. Enrique Cabrera, Secretaría de Salud, Ciudad de México, México; 3 Servicio de Urología, Centro Médico ABC; Servicio de Urología, Hospital Ángeles Lomas; Ciudad de México, México; 4 Departamento de Epidemiología Hospitalaria y Control de Infecciones Nosocomiales, Hospital General Dr. Manuel Gea González, Ciudad de México, México; 5 Servicio de Urología, Hospital Universitario Dr. Joaquín del Valle Sánchez, Instituto Mexicano del Seguro Social, Torreón, Coah. México
*Correspondence: Alejandro Madero-Arteaga. Email: alejandromadero22@gmail.com
Abstract
A review of the current literature was conducted in order to determine the role of urethroplasty in the treatment of urethral stricture that affects 0.6% of men. The etiology of anterior urethral stricture can be due to iatrogenic, traumatic, inflammatory and idiopathic causes. The etiology of posterior urethral stricture is pelvic fracture. Symptoms are nonspecific and can include lower urinary tract symptoms as well as infections. Retrograde urethrography is the study of choice for diagnosis. Treatment is classified into two groups: open surgery (formal urethroplasty) and endoscopic transurethral surgery. Urethroplasty is a long-lasting and definitive treatment. In short strictures, < 2 cm, primary excision-anastomosis urethroplasty is highly successful, with a success rate greater than 90% in primary and repeat procedures. In strictures > 2 cm, ventral or dorsal enlargement urethroplasty with buccal graft is the ideal technique, with successful long-term results in 90% of patients. The length of the stenosis is the main prognostic factor and the major criterion used to decide the type of treatment. Spongiofibrosis is another determinant of adequate treatment and final prognosis.
Keywords: Urethra. Stricture. Spongiofibrosis. Urethrotomy. Urethroplasty.
