Internal Urethrotomy in Male Urethral Strictures

  • U. Jonas


In 1957, Ravasini [11] described a urethrotomy with electrocautery under direct vision. Later, 1974, Sachse [14] used a sharp cold knife for the optical urethrotomy. With this technique, a 69 % success rate (62 out of 90) was achievied; however, in only 11 out of 28 patients in whom a recurrence was suspected (radiological examination) was a recurrent stricture finally proven. The use of the cold plate for urethral stricture treatment under optical control became very popular, especially due to the fact that the rate of recurrence was much lower in cold plate urethrotomy than after treatment with electrocauterization in which a high incidence of necrosis and scarring was observed. Furthermore, due to these good results, the indication for urethroplasty decreased tremendously. Today the internal optical urethrotomy using the cold knife is a standard procedure in urology, due to the following factors [15]:
  1. 1.

    Minimal and fast procedure

  2. 2.

    Precise controlled cut

  3. 3.

    Better tissue identification in comparison to the electric knife

  4. 4.

    Less necrosis and therefore lower incidence of recurrence

  5. 5.

    No problems with secondary operation in case of recurrence

  6. 6.

    No danger to potency





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© Springer-Verlag Berlin Heidelberg 1988

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  • U. Jonas

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