Complications and failures of endoscopic operations on the urethra

Objectives: There are still limited numbers of papers dealing with complications and failures of endoscopic operations on male urethra. We have analyzed personal experience of complications and failures of endoscopic operations on the urethra. Patients and methods: From 1994 till 2006 644 male patients with urethral stricture disease have been treated in Moscow Municipal Hospital and at the Institute of Urology. Totally, 802 operations have been performed. Age range was 16 to 89 years old. Follow-up varied from 36 months up to 9 years. Results: Good long-term outcome of internal urethrotomy as initial surgical treatment is 80,4%. In 19,4% cases failures after endoscopic treatment have been obtained but urethroplasties have been performed only in 4,9% patients. Other 14,7% of patients have been successfully managed by repeated urethrotomies. The intraoperative complications rates are: urethral perforation - 16 cases (2,5%), bleeding - 3 cases (0,5%). Postoperatively - significant urethral bleeding were in 20 cases (3,1%) and infections (urethritis - 22 cases, 3,4%, prostatitis - 36 (5,6%), and orchitis - 19 (2,6%)). Recurrences after initial endoscopic treatment were in 126 cases (19,6%). Urethroplasty have been performed to 28 patients and 98 have been managed endoscopically. Conclusion: Endoscopic management of urethral stricture disease is effective and safe.