Abstract: PD29-08
Sources of Funding: none

Introduction

To verify a correlation between the period of urethral stenting after endoscopic urethral realignment and the incidence of post-operative urethral stricture. This study was designed to evaluate the outcome of continuing urethral stenting till the gap between the 2 realigned urethral segments has been completely epithelialized.

Methods

Eighteen patients underwent endoscopic urethral realignment after traumatic disruption of the posterior urethra. Post-operative urethroscopy was done using the flexible cystoscope to assess the progress of urethral healing. The urethral Foley catheter that acted as a stent and also for urine drainage was removed when complete mucosal healing was observed by urethroscopy. Post-operative development of urethral stricture was noted and uroflowmetry was done at 12–36 months.

Results

Endoscopy 6 weeks after realignment showed 50%-75% epithelialization in all patients(figure 1). At 9 weeks, epithelialization was 100% in 15/18 patients (83%) and complete epithelialization at 12 weeks in all patients (figure 2). After stent removal, 1 patient (5.6%) developed a mild symptomatic stricture that was successfully treated by a single session of visual urethrotomy. All 18 patients had normal uroflowmetry readings at 12-36 months after realignment.

Conclusions

Following endoscopic urethral realignment, urethral stenting till mucosal healing was complete reduced the incidence of subsequent urethral stricture. Urethroscopy showed complete mucosal healing in 9–12 weeks after realignment. During a follow-up period of 12-36 month, 94.4% of the patients were symptom-free. Presence of asymptomatic large-caliber strictures or possibility of development of symptomatic strictures during longer follow-up periods can’t be ruled out.

Funding

none