Urethrotomy under direct vision: the primary treatment for urethral stricture.

Urethrotomy by direct visualization is highly successful in managing urethral strictures. The authors treated 55 patients by this method between 1978 and 1982. Thirty-four had undergone multiple dilatations previously and their unanimous agreement that visual urethrotomy was less painful and accompanied by fewer complications prompted the authors to use the latter method as the primary treatment in 21 patients, on an outpatient basis. The success rate in these 55 patients was 75%. The failure rate was 7%. The remainder were improved but had recurrent strictures, though less frequently than before visual urethrotomy. Because the procedure can be done on an outpatient basis, with a high success rate and minimal morbidity, the authors conclude that urethrotomy under direct vision should be the standard primary procedure for managing all urethral strictures.