Antegrade Urethral Approach for Urethral Stricture in Patients with Previous Failed Retrograde Intervention

IntroductionUrethral stricture has challenging difficulties in its treatment. Various treatment modalities had been used e.g.; urethral dilatation is one of the oldest methods. 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 am Platz renal dilator.MethodsThe total number of 15 patients with difficult urethral stricture and failed retrograde approaches were entered into the study. Guidewire 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, 6, and 12 months. The technique described was enabling us to get safe antegrade urethral access followed by stepwise retrograde am Platz renal dilation.ResultsThe mean age of patients was 39.2 ± 16.7 years. Preoperative uroflowmetry demonstrate Qmax 2ml/sec and ultrasonography showed PVR of 315ml ranging from 35 to1000ml. In post-operation uroflowmetry Qmax was raised to 19ml/sec (p-value

Keywords:

Antegrade , dilatation , Urethral stricture , Am Platz Dilators , Cystostomy