Comparison Of Optical Urethrotomy With Urethroplasty In Management Of Traumatic Bulbar Uretheral Stricture

Abstract

Background: Traumatic bulbar urethral strictures cause significant lower urinary tract morbidity. Optical Internal Urethrotomy (OIU) and urethroplasty are two commonly employed treatment options, each with distinct outcomes. Objective: To compare the efficacy, recurrence rates, and patient satisfaction between OIU and urethroplasty in managing traumatic bulbar urethral strictures. Study Design & Setting: This cross-sectional comparative study was conducted at Department of Urology HITEC-IMS, Taxila from January 2023 to December 2023. Methodology: A total of 120 male patients aged 18 to 65 years with traumatic bulbar urethral strictures were randomized into two groups: Group A (OIU, n=60) and Group B (urethroplasty, n=60). Patients underwent preoperative assessment, surgical intervention, and follow-up at 1, 3, and 6 months.  Primary outcomes included stricture recurrence, while secondary outcomes were operative time, hospitalization duration, complications, and satisfaction. Results: Stricture recurrence was significantly higher in Group A (35%) compared to Group B (10%) (p<0.05). Operative time and hospital stay were shorter in Group A (p<0.05). Postoperative complications were fewer in Group B, and patient satisfaction was significantly higher (p<0.05). Conclusion: OIU offers shorter operative times and hospital stays, but urethroplasty provides superior long-term outcomes with fewer recurrences and higher patient satisfaction. Urethroplasty remains the preferred option for definitive management.