Urethral stricture, the current role of urethroplasty. Literature review

Jorge A. Ruiz-Ortuño, Servicio de Urología, Hospital Regional de Alta Especialidad Centenario de la Revolución Mexicana, Instituto de Seguridad y Servicios Sociales para los Trabajadores del Estado, Emiliano Zapata, Mor., México
Eloy Rico-Frontana, Servicio de Urología, Hospital General Dr. Enrique Cabrera, Secretaría de Salud, Ciudad de México, México
Alejandro Madero-Arteaga, Servicio de Urología, Centro Médico ABC, Ciudad de México, México
Yunuen Rodríguez-Sánchez, Departamento de Epidemiología Hospitalaria y Control de Infecciones Nosocomiales, Hospital General Dr. Manuel Gea González, Ciudad de México, México
David Vargas-Villarreal, Servicio de Urología, Hospital Universitario Dr. Joaquín del Valle Sánchez, Instituto Mexicano del Seguro Social, Torreón, Coah. México

A review of the current literature was conducted in order to determine the role of urethroplasty in the treatment of urethral stricture that affects 0.6% of men. The etiology of anterior urethral stricture can be due to iatrogenic, traumatic, inflammatory and idiopathic causes. The etiology of posterior urethral stricture is pelvic fracture. Symptoms are nonspecific and can include lower urinary tract symptoms as well as infections. Retrograde urethrography is the study of choice for diagnosis. Treatment is classified into two groups: open surgery (formal urethroplasty) and endoscopic transurethral surgery. Urethroplasty is a long-lasting and definitive treatment. In short strictures, < 2 cm, primary excision-anastomosis urethroplasty is highly successful, with a success rate greater than 90% in primary and repeat procedures. In strictures > 2 cm, ventral or dorsal enlargement urethroplasty with buccal graft is the ideal technique, with successful long-term results in 90% of patients. The length of the stenosis is the main prognostic factor and the major criterion used to decide the type of treatment. Spongiofibrosis is another determinant of adequate treatment and final prognosis.

Keywords: Urethra. Stricture. Spongiofibrosis. Urethrotomy. Urethroplasty.