• Isr Med Assoc J · Apr 2020

    Comparative Study

    The Importance of Cystoscopy in Diagnosis and Treatment of Urethral Stricture Following Transurethral Prostatectomy.

    • Wasiem Abu Nasra, Muhammad Abu Ahmed, Alexander Visoky, Michael Huckim, Ibrahim Elias, and Ran Katz.
    • Department of Urology, Ziv Medical Center, affiliated with Azrieli Faculty of Medicine in the Galilee, Safed, Israel.
    • Isr Med Assoc J. 2020 Apr 1; 22 (4): 241-243.

    BackgroundTransurethral prostatectomy is the gold standard surgical treatment of bladder outlet obstruction due to benign enlargement of the prostate, with more than 30,000 procedures performed annually in the United States alone. The success rate of this minimally invasive procedure is high and the results are durable. The development of urethral stricture is a long-term complication of the procedure and is noted in about 2% of patients. The stricture narrows the urethral lumen, leading to re-appearance of obstructive urinary symptoms. Traditionally, the evaluation of the stricture was performed by retrograde urethrography. Advancements in the fields of flexible endoscopy allowed rapid inspection of the urethra and immediate dilatation of the stricture in selected cases.ObjectivesTo compare the efficacy of urethrography versus cystoscopy in the evaluation of urethral strictures following transurethral prostatectomy.MethodsA retrospective review was conducted of a series of 32 consecutive patients treated due to post-transurethral resection of prostate (TURP) urethral stricture.ResultsTwenty patients underwent both tests. In 16 there was concordance between the two tests. Four patients had no pathological findings in urethrography but had strictures in cystoscopy. All strictures were short (up to 10 mm) and were easily treated during cystoscopy, with no complaints or re-surgery needed in 24 months follow-up.ConclusionsCystoscopy was superior to urethrography in the evaluation of post-TURP strictures. Strictures where often short and treated during the same procedure. We recommend that cystoscopy be the procedure of choice in evaluating obstructive urinary symptoms after TURP, and retrograde urethrography be preserved for selected cases.

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