Ces Urol 2003, 7(4):14-19 | DOI: 10.48095/cccu2003023

Surgery of stricture, fistula and hypospadia of the urethra (own experience)

I. Novák, P. Kutílek, K. Baker, M. Louda

Urologická klinika Fakultní nemocnice a LF UK Hradec Králové, přednosta doc. MUDr. Petr Morávek, CSc.

The authors evaluate the results of surgery for urethral strictures (83), fistulae (5) and residual hypospadias after previous urethroplasty (2) in a group of 90 individuals operated on at the Department of Urology of Hradec Králové Faculty Hospital in the years 1996-2002. The strictures were 21x traumatogenic, 42x iatrogenic, 5x inflammatory and 14x of uncertain aethiology. All patients underwent previous unsuccessfull therapy. The authors state used techniques of the surgery: meatoplasty, urethroplasty with the use of a vascular skin flap, buccal graft or Snodgrass urethroplasty, resection urethroplasty, intubation urethroplasty and fistulorrhaphy. Two patients were operated in two stages (marsupialisation with subsequent urethroplasty with on lay vascular flap, urethroplasty with a vascular flap with subsequent urethroplasty with buccal graft). In other two patients vascular skin flap was combined with buccal graft in one-stage procedure.
All patients passed urine spontaneously after the surgery. It was necessary to reoperate in ten cases afer 4-75 (mean 41) months. Once there was a recidivant fistula, five times uretheral stricture and four times a diverticulum developed at the site of urethroplasty. In one of the patients diverticulum vas operated at first and subsequently a newly developed fistula. Dilations in three-month intervals are done in one case after meatoplasty. In one patient a permanent epicys-tostomy was necessary because of neurogenic urine retention despite of successfull urethroplasty. The patient refused the option of intermitent catheterisation.
Quality of life was improved in all spontaneously urinating patients, in their oppinion, after urethroplasty.

Keywords: uretra, striktura, píštěl, hypospadie, uretroplastika, fistulorafie

Published: September 1, 2003