The use of Amplatz renal dilators in the minimally invasive management of complex urethral strictures

INTRODUCTION: To present the outcomes of using Amplatz renal dilators in the management of complex urethral strictures. MATERIAL AND METHODS: From September 2011 to August 2015, 34 patients with complex urethral strictures were treated with Amplatz renal dilators assisted with internal urethrotomy. Evaluation included uroflowmetry, IPSS and post-void residual volume measurement. Under spinal anesthesia, sequential dilatations were performed with Amplatz renal dilators measuring from 8 Fr up to 24 Fr. Urethrotomy was sequentially performed. RESULTS: The mean stricture length was 2.6 (1.5–3.5) cm. Preoperative mean Qmax was 4.4( 3.2–9.6) ml/sec. From September 2011 to August 2015, 34 patients with complex urethral strictures were treated with Amplatz renal dilators assisted with internal urethrotomy. Evaluation included uroflowmetry, IPSS and post- void residual volume measurement. Under spinal anesthesia, sequential dilatations with Amplatz renal dilators over an 8 Fr stylet were performed up to 24 Fr. Urethrotomy was sequentially performed. PVR was 155 (75–380) ml. Postoperative mean Qmax at 1 month was 18.4 (14.6–21.8) ml/sec, p <0.001, at 6 months was 16.6 (9.8–18.2) ml/sec, p <0.003 and at 12 months was 12.7 (7.4–17.3) ml/sec, p <0.005. Accordingly, mean PVR was significantly improved postoperatively, at 32 (12–88) ml in 1 month, p <0.001, while at 6 months was 34 (28–101) ml, p <0.005 and at 12 months was 62 (38–115) ml, p <0.005. Only 8 patients (23.5%) had a stricture recurrence in the first nine months and were treated with Amplatz dilatations alone. CONCLUSIONS: The use of Amplatz renal dilators in combination with internal urethrotomy is a safe and effective technique for the endoscopic treatment of complex urethral strictures in patients unfit for reconstructive surgery