126 148
The prolonged time period in our study from the
appearance of symptoms until surgery (12 yr on average)
is proof of the difficulties that exist in its diagnosis and the
decision to intervene.
The degree of difficulty in its diagnosis seems to be
inversely related to the severity of the stricture. Seven of our
patients presented with a relevant stenosis, with a clearly
Table 1 – Patient symptoms and instrumental findings
Patients
1
2
3
4
5
6
7
8
9
Preop
characteristics
Symptoms
Urge
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Frequency
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Dysuria
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Weak stream Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Urinary
retention
No
Yes
Yes
Yes
No
No
Yes
No
No
Recurrent UTI
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Peak flow (ml/s)
7
1
1 a 0 b 0 b1
1 a5
3
17
8
Urethral calibration
12
12
6
6
16
10
10
18
8
Stricture site
Distal
Mid-
distal
Mid-
distal
Pan-
urethral
Pan-
urethral
Mid-
distal
Pan-
urethral
Mid-
distal
Mid-
distal
Postop
characteristics
Follow-up (mo)
198
102
60
48
27
96
166
18
12
Symptoms
Urge
No
No
No
No
No
No
No
No
No
Frequency
No
No
No
No
No
No
No
No
No
Dysuria
No
No
No
No
No
No
No
No
No
Weak stream No
No
No
No
No
No
No
No
No
PVR (
>
25 ml)
No
No
No
No
No
No
No
No
No
Recurrent UTI
No
No
No
No
No
No
No
No
No
Incontinence
No
No
No
No
No
No
No
No
No
Peak flow (ml/s)
24
35
14
18
30
15
19
20
15
Complications
No
No
No
No
No
No
No
No
No
Postvoid residual
volume
No
No
No
No
No
No
No
No
No
PGI-I
Very
much
better
Very
much
better
Very
much
better
Very
much
better
Very
much
better
Very
much
better
Very
much
better
Very
much
better
Very
much
better
PGI-I = Perception Global Impression of Improvement questionnaire; postop = postoperative; preop = preoperative; PVR = postvoid residual; UTI = urinary tract
infection.
a
Suprapubic catheter.
b
Periodical urethral dilatation.
[(Fig._3)TD$FIG]
Fig. 3 – The whole urethra was strictured, reaching up to 1 cm of the
bladder neck and remaining so throughout the whole time of exploration.
[(Fig._2)TD$FIG]
Fig. 2 – Narrow urethral segment with a dilated proximal urethra and
bladder neck during micturition.
E U R O P E A N U R O L O G Y 7 3 ( 2 0 1 8 ) 1 2 3 – 1 2 8
126