The impact of optical urethrotomy on the management of urethral strictures.

The introduction of optical urethrotomy by Sachse has reduced the need for urethroplasty: 261 urethroplasties were performed between 1964 and 1983, of which 87 were performed in one stage on patients who would today have undergone urethrotomy as the procedure of first choice. The results in this group are compared with those in 151 patients treated between 1978 and 1983 by 265 internal optical urethrotomies. At 5 years 50% of those treated by urethrotomy needed no further treatment, compared with 83% of those treated by urethroplasty. Nevertheless, the ease and safety of urethrotomy makes it the procedure of first choice, and urethoroplasty should be reserved either for cases where urethrotomy is unsuitable or where it has been tried on several occasions without success.