Urethral obliterations: diagnosis and treatment

Abstract

Introduction. Urethral obliteration is a progressive narrowing of the urethral lumen, being a typical urology disorder manifested by symptoms of strangulation and dizziness and always has a spreading tendency. The priority option in the treatment of urethral obliterations is optical internal urethrotomy (UIO) with a 85% success rate, but the rate of postoperative recurrences is 15%. Aim of the study. The comparative determination of the results of surgical interventions (urethral plastic and endoscopic urethrotomy), determination of the role of open therapy in urethral obliterations and identification of different ways and possibilities of using endoscopic methods integration in the respective urethral obliteration treatment stages. Materials and methods. In order to fulfill these tasks and achieve the aforementioned aim an analysis of the results of conservative and surgical treatment in 110 patients with urethral obliterations in the "Urology and Surgical Nephrology" clinic during the period 2015-2017 was made. The first batch includes 70 patients with urethral obliteration of posttraumatic etiology. The second group included 40 patients with urethral obliteration of post-inflammatory etiology. Results. Urethral obliteration is diagnosed by cystoscopic examination, retrograde urethrography, urinalysis, uroflowmetry, urine culture, contrast cistouretrography. As a result of urethral obliterations treatment through UIO (optical internal urethrotomy), the urethra permeability was restored in the shortest possible time, the duration of the hospitalization was shortened (7 days vs 17 days after Holtov Marion and 25 days after Solovov-Badenoc), having a great acceptance from the patients. Conclusions. It has been shown that the intervention of choice in the treatment of urethral obliterations is endoscopic. The results of surgical and conservative treatment performed in patients with urethral obliterations have determined the role and dependence of its efficacy, significantly increasing its therapeutic value.