COMPARATIVE STUDY BETWEEN DIFFERENT TECHNIQUES IN TREATMENT OF STRICTURE JRETHRA BY ENDOSCOPIC MANIPULATIONS

Abstract

Urethral stricture is one of the oldest urologic problems. It may occur as a result of urethral trauma, urethritis, iatrogenic causes or as a congenital malfonnation . Urethral stricture can be diagnosed clinically, radiol­ ogically and endoscopically. Ascending urethrography and urethra-cystoscopy are the main modalities for diagnosis of urethral stricture. Management of urethral stricture is a challenge for the urologists because there is no best line of treatment for those patients. However, advances in endoscopic treatment provides a safe and effective line of management. Patient with urethral stricture can be managed by :- • Periodic outpatient urethral dilation: at frequent intervals. It is indicated in passable, dilatable and non­ complicated stricture . • Otis internal urethrotomy : with blind transurethral incision of urethral stricture . It can be used in long stricture if it is wide enough to admit the urethrotom. • Visual internal urethrotomy : Ideally it is indicated in patients with short ring stricture in the anterior urethra that is not associated with spongiosa! fibrosis . It can also be applied for patients with failed urethroplasty and in post-traumatic urethral stricture in children . • Urethral stents : It provides a simple and effective alternative techniques to repeated urethrotomies. or dilation . It is of two types either temporary or permanent.