Internal urethrotomy in the management of anterior urethral strictures: Long-term followup

Purpose: We evaluated the long-term results of internal urethrotomy for anterior urethral strictures. Materials and Methods: Between 1975 and 1990, 224 patients underwent internal urethrotomy for anterior urethral strictures. Median followup was 98 months (range 60 to 216). Results: The recurrence rate after 1 urethrotomy was 68% overall, and 58% for bulbar, 84% for penile and 89% for penile bulbar urethral strictures. Repeated urethrotomies did not improve the success rate. Prognostic characteristics of bulbar urethral strictures associated with good results included single or primary strictures, length shorter than 10 mm, and caliber wider than 15F. Preoperative infection and etiology of the strictures did not correlate with results. Multiple urethrotomies achieve only temporary improvement and can be compared to repeated dilations. Conclusions: Alternative treatments should be considered for penile strictures and after failure of initial urethrotomy.