Simultaneous treatment of anterior urethral stricture and benign prostatic hyperplasia: primary experience overview

Abstract

Introduction. Research on the treatment of patients with a combination of anterior urethral stricture and benign prostatic hyperplasia (BPH) is basically absent in the worldwide literature.Objective. To analyse the primary experience results with simultaneous treatment of anterior urethral stricture and BPH.Materials & methods. The study included four patients with anterior urethral stricture and BPH, who underwent simultaneous surgical treatment including perineal / penile urethrostomy and thulium laser enucleation of the prostate. The success criterion for treatment was considered to be the absence of obstructive lower urinary tract symptoms requiring the use of endoscopic or open surgery, regardless of whether urethrostomy was considered as the first step or the final option for urinary diversion.Results. The age of the patients ranged from 54 to 69 years (mean 63.0 ± 6.5 years). In one (25%) patient the stricture was localised in the penile urethra and in three (75%) patients it was localised in the bulbous urethra. The stricture length ranged from 1.0 to 3.0 cm (mean 2.1 ± 0.9 cm). The prostate volume varied from 45 to 77 cc (mean 63.8 ± 13.5 cc). One patient had cystostomy drainage. The post-void residual volume among 3 patients with preserved urination ranged from 90 to 130 ml (mean 113.3 ± 20.8 ml). Postoperative follow-up periods ranged from 3 to 18 months (mean 11.3 ± 7.4 months). At these follow-up periods, treatment was successful in all four (100%) patients. No intra- or postoperative complications were observed.Conclusions. The proposed method can be successfully applied in patients with a combination of anterior urethral stricture and BPH. However, the final guidelines for the management of such patients can be developed after further research.

Keywords

• urethral stricture
• benign prostatic hyperplasia
• transurethral resection
• laser enucleation
• thulium laser