Urethral strictures are initially managed with dilation by using sequential metal sounds or filiform and follower dilators. These techniques more successfully achieve at least a temporary rise to the caliber of the area of stricture, they are done without visual guidance, and risks may include false passage and urethral perforation.
PROCEDURE:
-
This balloon dilator consists of a 5F, 80-cm open lumen and blunt tip catheter with a marked 4-cm length and 10-mm diameter (approximately 30F) balloon.
-
Consequently, the balloon has been used as a chosen procedure when dilation is indicated. Our treatment approach to patients with urethral stricture disease is initially to perform urethroscopy, voiding cystourethrography and retrograde urethrography.
-
Patients are informs that dilation is a sensible option for the primary management of strictures <1.5 cm, and open repair usually is the good option for the management of longer or recurrent strictures if the goal is cure. Some patients who are suffering with multiple health problems and radiation strictures in particular wish to be managing with repeated dilations. This method can be used in the hospital by using only 2% intraurethral lidocaine jelly, particularly in patients who have tolerated dilation well in the past.
-
This method was performed in the operating room under spinal or general anesthesia. Patients are positioned in the lithotomy position. Rigid cystoscopy is done, because the 30F balloon does not advance from flexible cystoscopes. When the distal aspects of the stricture are visualized, a flexible tip guidewire is complex.
-
Once access is established from the stricture, the catheter is then advanced above the guidewire under direct view, and the balloon is placed across the stricture.
-
The balloon was slowly inflated to 10 ATM for 5 to 10 minutes by the water (maximum inflation is 12 ATM) under direct vision by using a Leveen insufflator, exerting gentle, gradual radial pressure localize to the area of stricture. Even though the balloon can be inflated by using radiopaque contrast to allow fluoroscopic visualization.
-
The balloon is then deflated, and detached. Because the cystoscope is already neighboring to the distal aspect of the stricture, the scope can then be upgraded proximally to examine the dilated area and the urethra proximal to the stricture.
