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2016 ; 32
(1
): 27-33
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Current management of urethral stricture disease
#MMPMID26941491
Smith TG 3rd
Indian J Urol
2016[Jan]; 32
(1
): 27-33
PMID26941491
show ga
INTRODUCTION: Broadly defined, urethral strictures are narrowing of the urethral
lumen that is surrounded by corpus spongiosum, i.e., urethral meatus through the
bulbar urethra. Urethral stenosis is narrowing of the posterior urethra, i.e.,
membranous urethra through bladder neck/prostate junction, which is not enveloped
by corpus spongiosum. The disease has significant quality of life ramifications
because many times younger patients are affected by this compared to many other
urological diseases. METHODS: A review of the scientific literature concerning
urethral stricture, stenosis, treatment, and outcomes was performed using Medline
and PubMed (U.S. National Library of Medicine and the National Institutes of
Health). Abstracts from scientific meetings were included in this review.
RESULTS: There is level 3 evidence regarding the etiology and epidemiology of
urethral strictures, stenoses, and pelvic fracture urethral injuries. Outcomes
data from literature regarding intervention for urethral stricture are largely
limited to level 3 evidence and expert opinion. There is a single level 1 study
comparing urethral dilation and direct vision internal urethrotomy. Urethroplasty
outcomes data are limited to level 3 case series. CONCLUSIONS: Progress is being
made toward consistent terminology, and nomenclature which will, in turn, help to
standardize treatment within the field of urology. Treatment for urethral
stricture and stenosis remains inconsistent between reconstructive and
nonreconstructive urologists due to varying treatment algorithms and approaches
to disease management. Tissue engineering appears to be future for reconstructive
urethral surgery with reports demonstrating feasibility in the use of different
tissue substitutes and grafts.
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