CONVENTIONAL TREATMENT

 

·         In Urethral dilatation, either Metal or Teflon dilators of different size are introduced into urethra under anesthesia.

·         Dilators are introduced starting with a smaller size & then larger size

·         Also called as serial dilatation or birthday dilatation



BALLOON DILATATION

·         The procedure of dilatation of urethra using a Balloon catheter.

·         It is done either under local anesthesia or under short general anesthesia.

URETHROTOMY VIU / DVIU

·         In this under anesthesia a cysto-urethroscope is introduced into the urethra, the fibrotic scar tissue is cut open to release the stricture.

·         Different techniques are used including simple blade i. e. urotome, cold knife, and different lasers such as Holmium and Thulium laser.

URETHROPLASTY

Urethroplasty is supposed to be the last resort for the management of urethral stricture. It is major open surgery. There are different types of urethroplasty. For short segment strictures, that much part of the urethra is excised and the two openings are joined together, this is called Anastomosis urethroplasty. For long or linear strictures, urethroplasty is performed in different ways. The commonest is Buccal Mucosal Graft Reconstructive Urethroplasty. In this, the constricted part of the urethra is excised and the buccal mucosa is used to reconstruct it. Unfortunately, stricture recurs even after urethroplasty and the patient has to involve in the same circle of VIU, dilatation & clean intermittent self-catheterization.

SELF CATHETERIZATION / SELF DILATATION / CLEAN INTERMITTENT SELF CATHETERIZATION (CISC)

·         Patients are taught to introduce catheter into urethra on their own using an anesthetic gel

·         This is done to maintain the caliber of urethra

·         Usually advised after urethral dilatation, VIU & Urethroplasty

·         Caliber of urethra reduces even after regular self catheterization & stricture recurs

·         Certain complications are involved with self catheterization –

·         Recurrent UTI

·         Injury

·         Rupture urethra

·         New scar formation

·         Multiple strictures

·         False Passage

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