To assess the impact of prior urethral dilatation or DVIU on the outcome of anterior urethroplasty.
Keywords:Urethral Stricture, Urethroplasty, Direct Visual Internal Urethrotomy, Urethral Instrumentation.
Background: Male urethral stricture has remained the major problem in urologic practice. Patients presenting with urethral stricture disease are commonly managed by dilatation, DVIU, and urethroplasty.
Methodology: This is a descriptive study of male patients who underwent anterior urethroplasty at our setup from 5th August 2021 to 25th February 2022. We analyzed the age, duration, type, length, and location of the stricture and the surgical treatment outcome after urethroplasty. The post-operative catheter was removed after 3 weeks, and UFM is advised. Qmax (max flow rate) > 15 ml/sec was measured on UFM (uroflowmetry) on the 1st week, 6 weeks, and followed on 3 months. Final outcome in terms of success was assessed by uroflowmetry. A maximum urine flow greater than 15mL/s after 3 months’ treatment assessed by uroflowmetry was considered as success.
Results: In our study, the blood loss in group A and group B patients, those patients who had DVIU or dilation in the past, had more bleeding during surgery than those who did not have a history of surgery. 66.67% of group B patients have bleeding from 200 ml to 500 ml, which is higher than group A patients. In our study, we found that if the patient had undergone surgery or no surgery had taken place before urethroplasty, the results in terms of UFM were quite similar, as in group A, 96.69% of patients had UFM more than 15 ml/sec, and in group B 87.88% had UFM more than 15 ml/sec.
Conclusion: Urethral dilatation or DVIU delays definitive treatment and increases operative challenges by increasing the length of stricture, more adhesion, and more fibrosis but has minimal impact on the outcome of urethroplasty success.
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