Antegrade urethral accessing for treatment of difficult urethral stricture in patient with failed retrograde approach

Document Type: Original Article

Authors

1 medical doctor, Shahed university , Tehran Iran

2 Department of urology Mustafa Khomaini Hospital, Shahed University Tehran, Iran

10.22034/tru.2020.251313.1034

Abstract

Introduction:
Urethral stricture has challenging difficulties in its treatment. Various treatment modalities had been used e.g. urethral dilatation is one of the oldest method. Severe bleeding and several false passages may end to failure, which may make retrograde access impossible. The purpose of this study was to describe safety in antegrade accessing followed by retrograde dilatation with amplatz renal dilator.
Materials and Methods
Total of 15 patients with difficult urethral stricture and failed retrograde approaches were entered study. Guide wire was passed through the cystostomy for proper retrograde accessing which was delivered through external urethral meatus followed by retrograde dilation. Patient parameters were analysis, all patients had retrograde urethrography (RUG) pre and post-operative, max flow rate (Qmax) on uroflowmetry (UF) in addition to post voiding residual urine (PVR). Patients were followed at 2, 6and 12months, the technique describe were enabling us to get safe antegrade urethral accessing followed by stepwise retrograde amplatz renal dilation.
Results
The mean age of patients was 39.2 ± 16.7(17- 83) years. Preoperative uroflowmetry demonstrate Qmax 2(0-9) ml/sec and ultrasonography showed PVR of 315(35- 1000) ml. In post-operation uroflowmetry Qmax was raised to 19(15-22) ml/sec (P

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