Minimally invasive treatment of urethral strictures in men

Abstract

Minimally invasive treatments of urethral strictures in men intend to durably restore normal anatomy and function with relief of urinary symptoms and avoidance of morbidity. Minimally invasive treatments for bulbar urethral strictures include bougienage and coaxial balloon dilation, endoscopic urethrotomy with a cold-knife or laser, and urethral wall stents. Adjunctive techniques including brachytherapy and the injection of steroids, mitomycin C, or captopril, have been employed to reduce the high restricture rates with minimally invasive treatments for bulbar urethral strictures. This review discusses recently published data concerning indications for these commonly performed minimally invasive procedures, along with their efficacy, durability, and potential for adverse events. Although many currently available studies report on small numbers of patients, some conclusions can be made. Ultimately, long-term, randomized, controlled prospective studies of larger numbers of men with bulbar urethral strictures are needed.