BACKGROUND:

Urethral stricture is an alteration that reduces urine flow and hampers bladder voiding. Its origin is multifactorial and there is no definitive consensus on approach or standard treatment.

OBJECTIVE:

To determine the recurrence of bulbar urethral stricture in patients that underwent primary anastomotic urethroplasty or primary internal urethrotomy.

MATERIALS AND METHODS:

A retrospective cohort study was conducted on patients that underwent anastomotic urethroplasty or internal urethrotomy within the time frame of 2007 and 2014 at the Hospital General Dr. Manuel Gea González, in Mexico City. The preoperative characteristics analyzed were: age, urinary retention, etiology, length and location of the strictured segment, preoperative and postoperative uroflowmetry (Qmax) results, stricture recurrence, and treatment after recurrence.

RESULTS:

Thirty-one (22.3%) patients that underwent anastomotic urethroplasty and 108 (77.7%) that had internal urethrotomy were registered. Mean patient age was 54.12 ± 14.6 years and the most frequent etiology was iatrogenic (57.6%), followed by traumatic causes (29.5%), idiopathic causes (8.6%), and infectious origin (4.3%). Mean stricture length was 13.20 ± 4.9 mm, 5.8% of patients had urinary retention, preoperative Qmax was 6.81 ± 1.53, and postoperative Qmax was 11.78 ± 2.44 mL/sec. There was no recurrence at 6 months in the patients that underwent anastomotic urethroplasty. Recurrence in the patients that had internal urethrotomy was 43.9%. Postoperative Qmax was 10.77 ± 1.82 mL/sec in the patients that had recurrence at 6 months vs 12.5 ± 2.59 mL/sec in those that did not have recurrence (p=0.002).

CONCLUSIONS:

Anastomotic urethroplasty can be considered firstline treatment in patients with bulbar urethral stricture ≤2 cm in length. Internal urethrotomy is the minimally invasive surgical treatment of greater availability in urologic practice.

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