Abstract
THE USE OF TEFLON SERIAL DILATORS FOR URETHRAL DILATATION: OUR INSTITUTIONAL EXPERIENCE

Sangameswaran Palanisamy* and Arun Prasadh T. P.

ABSTRACT

Objective: Urethral stricture is one of the morbid conditions in which patients require frequent hospital visits and admissions. More severe cases may present with complete retention, bladder stones, or recurrent urinary tract infections (UTIs).[1][2] Urethral dilation, optical internal urethrotomy, or open surgical reconstruction (urethroplasty) are few options available for urethral stricture management. Urethral dilation is done with metal dilators, teflon dilators, filiforms and followers, balloons, or coaxial dilators inserted over a guidewire. The Teflon was designed to facilitate the passage of the dilator over a guidewire through the stricture and the urethra with less pain and trauma. This study presents our experience with Teflon urethral dilatation. Materials and Methods: Total 360 patients had undergone teflon dilatation between 2017 August and 2022 August. The technique included the insertion of a hydrophilic floppy-tipped guidewire through the urethra directly into the bladder under direct vision or fluroscopy. The Teflon dilators were then inserted over the guidewire. Dilators of gradually increased size from 8F to 24F were used. The follow-up of the patients includes uroflowmetry and measurement of postvoid residual at 4 weeks, or in the case of a recurrence of symptoms. Results: The age of the patients were 69.08 ± 15.77 years. The causes of urethral stricture were iatrogenic (n = 132), traumatic (n = 41), infectious (n = 26), and of unknown origin (n = 161). The stricture length was 1.52 ± 0.75 cm. The mean number of dilations needed per case was 4 (range: 1–15), and the time between the dilations is 3 to 4 weeks. Conclusion: Teflon dilators for urethral dilation as a safe and effective technique because of their atraumatic cone shaped tip design and it is malleable so that it can negotiate into the male urethra with ease.

Keywords: Teflon, dilation, lower urinary tract symptoms, urethral stricture.


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