SURGICAL REPAIR OF TRAUMATIC URETHRAL STRICTURE

Abstract

Since 1974, we have treated 100 cases of urethral stricture including 32 cases of traumatic origin.
The thirty-two traumatic urethral stricture cases consisted of 12 bulbous (37.5%), 19 membranous (59.3%) and 1 meatal (3.1%) stenosis.
In 10 out of the 32 cases, internal urethrotomy was performed. It was successful in 8 cases except one missing case. The rest of the patients were treated by end-to-end anastomosis method in 6, Badenoch method in 15 and Michalowski method in one case. In no case failure of surgery was noted.
Except for 1 internal urethrotomy case requiring secondary urethroplasty, no re-operation was needed and none of them is visiting our clinic for urethral dilatation.
As for complication, complete urinary incontinence due to iatrogenesis in 1 case, complete sexual impotence in 2 cases and incomplete impotence in 2 other cases were noted.
Impotence following surgery may be attributable to severity of injury, aging and psychological influence of monetary compensation relating to trauma.
Pre-operative diagnosis as to the location of stricture, whether bulbous or membranous, is mandatory for successful urethral repair.