Urethral Dilatation after Urethrotomy for Urethral Stricture: A VMMC Protocol

Abstract

Objective: To document the VMMC Urethral Dilatation Protocol, established in Veterans Memorial Medical Center for male patients with urethral stricture who underwent urethrotomy and to determine if there is a significant difference in the International Prostate Symptom Score and Uroflowmetry studies after urethral dilatation in male patients with urethral stricture who underwent urethrotomy.

Materials and Methods: The is a descriptive, retrospective chart review of male patients in Veterans Memorial Medical Center diagnosed with urethral strictures via voiding cystourethrogram or flexible cystoscopy who underwent urethrotomy. A total of 24 patients were enrolled in this study, all of whom were post TURP patients. All patients with recurrent urethral stricture, history of trauma and patients with infectious causes of stricture were excluded. Each patient's International Prostate Symptom Score and Uroflowmetry studies prior to urethrotomy and post urethrotomy who underwent the VMMC urethral dilatation were collected. Median and range (Minimum-Maximum) were used to describe the variables of the study. These variables are IPSS, peak flow rate, average flow rate, voided volume, and residual volume.

Results: The IPSS, was statistically lower after urethrotomy with urethral dilatation and the uroflowmetry parameters (peak flow rate, average flow rate, voided volume, and residual volume) were statistically improved after urethrotomy with urethral dilatation.

Conclusion: The Urethral Dilatation Protocol established in Veterans Memorial Medical Center and which is done every week for 1 month, then every 2 weeks for another 1 month, and monthly until there is markedly improved International Prostate Symptom Score showed that this timing may help improve IPSS and patient symptoms but not lessen recurrence rates.