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Management of Urethral strictures, Internal urethrotomy, Urethroplasty,…
Management of Urethral strictures
Internal urethrotomy
:checkered_flag: Performed with optical uretherotome
Rigid uretheroscope
Catheter in situ for 1-3 days
Endoscopic procedure
Complicated by false passages in previous dilatation attempts
Uncomplicated strictures
Short strictures within bulbar urethra
Urethroplasty
:checkered_flag: Excision of stenosed length and reanastomosis
Free grafts usually buccal (tough, good vascularity, moist, no morbidity)
maybe
Penile
Lingual
Bladder
Not possible within penile urethra
not stretchy
Recurring strictures
after endoscopy
Used in short strictures with traumatic history
Preoperative ascending descending urethrography vital
Urethral dilatation
Used in recurrent strictures where urethroplasty is not needed
Intermitted self dilatation with soft hydrophilic catheters on regular basis
:checkered_flag: Performed blind under LA
Used in elderly with short strictures
Old procedure