Core-through optical internal urethrotomy in management of impassable traumatic posterior urethral strictures.

During a 2 1/2-year period 10 patients with a traumatically obliterated posterior urethra underwent core-through optical internal urethrotomy 3 to 6 months after pelvic fracture. After 6 to 24 months of followup the peak urine flow rate was more than 15 ml. per second in 6 patients and 8 to 15 ml. per second in 2. Six patients were continent and 2 had transient stress urinary incontinence. Of the 10 patients 2 were failures because of peak urinary flow rates less than 8 ml. per second and/or urinary incontinence. Subsequently, 1 patient underwent successful scrotal flap urethroplasty. Core-through optical internal urethrotomy is an attractive alternative to urethroplasty when the impassable stricture is short.