Yaser Ahmad^1*, Rouf Khawaja², Manzoor Ahmad³, Sajad Malik⁴, Saleem Wani⁵, Arif Hameed⁶

¹Senior resident; ²Consultant, ³Resident Urology, ⁴Consultant, ⁵Consultant &Head of Department,⁶Consultant SKIMS, Soura, Srinagar, Jammu & Kashmir, India

*Corresponding Author

Dr. Yaser Ahmad                                                                                                               

Email: yasserahmad009@gmail.com                                                                           

Abstract:

Background: Recently, interest has been generated in using cystoscopy as an adjunct in management of urethral stricture disease owing to its diagnostic and therapeutic capabilities. However the feasibility of this technique as an adjunct for diagnosing and management of PFUDD are limited.

Objective: To assess the advantage of performing the antegrade and retrograde cystoscopy during PFUDD repair

Methods: Thirty one perineal urethroplasties combined with antegrade and retrograde cystoscopy was performed on study participants from 2014 to 2018. Informed consent was obtained from all patients. The etiology of lesions, findings of RGU/MCU and operative records of the patients was evaluated, with particular focus on antegrade and retrograde cystoscopy findings during urethroplasty. Data on postoperative outcome were also assessed.

Results: We performed 31 perineal urethroplasties in thirty one patients with mean age of 38 (17- 72) years. The mean defect length was 2.5 cm (range 1-7.5 cm). All the defects were located in posterior urethra however one patient had urethro-cutaneous fistula located in anterior urethra. Lesions were secondary to pelvic trauma in all the patients. Mean duration of follow up was 19 (3-38) months. In 27 patients controlled physiological micturition was achieved without any additional intervention. The mean maximum urine flow was 16.5 ml/s and average flow was 12 ml/s on uroflowmetry (Fig 8). However in 2 patients optical urethrotomy was required at 3 months post procedure and in other 2 patients metallic dilation was needed after three weeks post catheter free trial.

Conclusion: Cystoscopy is an easy to perform adjunctive modality in PFUDD repair and can be used without incurring any considerable additional cost.

Key words:  cystoscopy, modality, PFUDD, repair, cost