Clinical Analysis Of200Adult Male Patients With Urethral Strictures

Objective:To study the treatment methods for urethral stricture and its therapeutic effect.Methods:The clinical data of200patients with urethral strictures from January2009to December2012was analyzed retrospectively in the1st affiliated hospital of Zhejiang University.The mean age was (50.7±15.4) years old (range from18-87years old).Repair was performed with DVIU in75patients, plasma eletrosection in23patients,balloon dilatation in7patients,end-to-end anastomosis in64patients, different procedures urethroplasty in53patients. Followup ranged from3to36months.Results:Trauma is the main cause of urethral strictures, including72patients of pelvic fractures(36%) and straddle injury in28cases(14%).Stricture length and preoperative comorbidities were negatively correlated to the surgical results. For the patients with narrow segment≤lcm, success rate of DVIU reached88.2%.For complexity of anterior urethral urethroplasty, the overall success rate was83.3%in the penis and80%in the bulbar urethra. The success rate of end-to-end anastomosis in bulbar urethra was91.7%,while69.2%in the membranous urethra. Conclusion:Selection of treatment method for urethral stricture depends on stricture length,location and severity.For the patients of narrow segment≤1cm,DVIU is the best treatment method.End-to-end anastomosis has higher sucess rate in bulbar urethra stenosis than in membranous urethra stenosis.Urethroplasty with autologous tissue is an important method for the treatment of anterior urethral complex urethral stricture, but the long-term efficacy remains to be further evaluated.