Intraurethral brachytherapy for prevention of recurrent urethral strictureafter internal urethrotomy or transurethral resection of scar

Background Purpose: Restricture after internal urethrotomy is the major lim itation to the long-term success of the procedure. The objective of this st udy was to evaluate the effect of intraurethral brachytherapy after interna l urethrotomy or transurethral scar resection on recurrent urethral strictu re. Patients and Methods: From January 1998 to June 1999, catheter-based intrau rethral brachytherapy with 192-iridium was performed in 17 patients with re current urethral stricture to prevent restricture after internal urethrotom y or transurethral resection of scar. The radiation was repeated within 3 d ays after surgery to reach a total dosage of 1000 to 1500 cGy. Results: During the follow-up (range 14-27 months; mean 20 months), two pat ients had dysuria, including one patient with an atonic detrusor muscle. Th e other patient needed self-dilation. Fifteen patients presented normal voi ding. The stricture recurred 3 months later in only one patient, so the res tricture rate is 7%. No significant complication was observed associated wi th brachytherapy during the follow-up. Conclusion: Intraurethral brachytherapy after internal urethrotomy or trans urethral resection of scar is a safe and effective treatment for recurrent urethral strictures.