Abstract

Between May 1992 and June 2001, we performed reconstructive urologic surgery on 32 patients, aged between 13-74, due to posterior urethral strictures. There was complete urethral disruption in 28 cases following pelvic trauma, there were partial strictures in 3 cases after transvezical prostatic surgery and an iatrogenic stricture in 1. Except the 9 cases who were only cystostomised at the time of pelvic trauma, all had a history of previous unsuccessful multiple internal urethrotomies (OIU). We performed one-stage resection and bulbo-prostatic anastomosis through a perineal incision 3-6 months after the last surgical procedure. Strictures were between 1 and 5 cm in length. Patients were followed with uroflowmetry and urethrography for 6 to 52 months (mean 13,5 months). No success was achieved in 2 postprostatectomy and in 1 posttraumatic patient, who were initially managed with multiple OIU’s. 3 of the remaining 29 have been followed with urethral dilatations. In 3 cases stress urinary incontinence and in 1 case impotence is reported. There is functional and radiological improvement in 26 patients. In posterior urethral strictures, surgical success depends on detailed preoperative evaluation of the stricture and careful application of proper surgical procedures. Thus, many of dilatations and OIU procedures, which in fact may be harmful to the patients can be avoided.