SACHSE URETHROTOMY VERSUS ENDOSCOPIC URETHROTOMY PLUS TRANSURETHRAL RESECTION OF THE FIBROUS CALLUS (GUILLEMINS TECHNIQUE) IN THE TREATMENTOF URETHRAL STRICTURE

Objectives. Advances in endoscopic instrumentation and techniques have expanded the urologist's armamentarium for effective and safe treatme nt of urethral strictures. This prospective study included 80 patients who presented with single, iatrogenic, annular strictures of the bulb ar urethra. The length of the stricture was 1 to 2 cm, with an average of 1.5 cm. Methods, Patients were randomly divided into two groups: g roup A, 40 patients who underwent direct-optical endoscopic urethrotom y with a guide catheter via cold-knife incision at the 1 2 o'clock pos ition (Sachse urethrotomy), and group B, 40 patients who underwent dou ble direct-optical endoscopic urethrotomy with a guide catheter via co ld-knife incisions at the 1 1 and 1 o'clock positions, followed by tra nsurethral resection of all scar tissues (Guillemin's technique). The results obtained were analyzed and compared at 6 months, 12 months, 24 months, 3 years, and 5 years postoperatively by clinical evaluation, uroflowmetry, and retrograde and voiding urethrographies. Results. Gro up A obtained 95% good results at 6 months, 85% at 12 months, 55% at 2 4 months, 45% at 5 years, and 25% at 5 years. Group B obtained 98% goo d results at 6 months, 95% at 12 months, 90% at 24 months, 80% at 3 ye ars, and 70% at 5 years. Conclusions, The differences between the two groups are not significant at 6 and 12 months (P > 0.05). They are sta tistically significant after 24 months, 5 years, and 5 years (P < 0.05 ). Copyright 1997 by Elsevier Science Inc.