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ResumenAntecedentesLa estenosis uretral es una enfermedad urológica, con una morbilidad significativa. La uretrotomía interna de visión directa (UIVD) se utiliza para la mayoría de los casos en los Estados Unidos, sin embargo la uretroplastia término-terminal es la técnica más resolutiva. Existe controversia en la elección del manejo primario. La UIVD reporta tasas de éxito menores a largo plazo. En México, en la mayoría de las instituciones tiene gran aceptación la UVID. La uretroplastia está indicada para estenosis largas y densamente fibróticas. El diagnóstico se basa en el estudio radiológico (contrastados, RMN o USG). Existen escalas (Urethral Stricture Score) que describen la complejidad de la estenosis para la elección de tratamiento quirúrgico.ObjetivoComunicar los resultados del tratamiento primario de la estenosis de uretra en pacientes del Hospital General Dr. Manuel Gea González, sometidos a uretroplastia término-terminal.Material y métodosEstudio descriptivo, 210 pacientes con estenosis de uretra, 58 sometidos como tratamiento primario a uretroplastia término-terminal en el periodo 1 de enero de 2007 al 31 de diciembre de 2013.ResultadosMediana de edad 46.4 años. Etiología: traumática 23%, yatrógena 58%, idiopática 17%, infecciosa 2%. La localización más frecuente de estenosis fue a nivel bulbar (87.9%) (51), longitud promedio 2.12cm, 3 casos presentaron doble sitio de estenosis, 11 (19)% de los casos se presentaron con retención urinaria, media de USS 5.8, 10 recurrencias, 9 reintervenciones (UTI), una uretroplastia de aumento. Qmáx prequirúrgico de 5.7 - 10ml/seg, Qmáx posquirúrgico 13–16ml/seg. Cura en 82.7% de los casos.ConclusionesA nivel mundial se reportan tasas de éxito de la uretroplastia del 84–97%, los resultados se relacionan con la complejidad de la estenosis y experiencia quirúrgica. Aún no existe un consenso de parámetros de éxito. La uretroplastia presenta menos recurrencias comparada con UVID, favoreciendo la calidad de vida a largo plazo.AbstractBackgroundUrethral stricture is a urologic disease that has significant morbidity. Direct visual internal urethrotomy is used for the majority of cases in the United States, but end-to-end urethroplasty is the most successful technique. The choice of primary management is controversial. Direct visual internal urethrotomy is widely accepted in the majority of Mexican hospital centers. However, it is reported to have lower long-term success rates. Urethroplasty is indicated for long, densely fibrotic strictures. Diagnosis is based on radiologic studies (nuclear magnetic resonance or ultrasound, with contrast medium). Scales (Urethral Stricture Score) describing stricture complexity are employed to choose surgical treatment.AimsTo communicate the results of primary treatment for urethral stricture in patients at the Hospital General Dr. Manuel Gea González that underwent end-to-end urethroplasty.Materials and MethodsA descriptive study was conducted that reviewed the case records of 210 patients with urethral stricture, selecting the 58 cases that underwent end-to-end urethroplasty as primary treatment within the time frame of January 1, 2007 and December 31, 2013.ResultsThe median age of the patients was 46.4 years. Stricture etiology: traumatic 23%, iatrogenic 58%, idiopathic 17%, and infectious 2%. The most frequent stricture location was at the bulbar level (87.9%) (51), mean length was 2.12cm, 3 cases presented with double-site stricture, 11% (19) of the cases had urinary retention, and the mean urethral stricture score was 5.8. There were 10 recurrences, 9 re-interventions (urinary tract infection), and one augmented urethroplasty. Preoperative Qmax was 5.7-10ml/sec and postoperative Qmax was 13-16ml/sec. Cure was achieved in 82.7% of the cases.ConclusionsUrethroplasty success rates worldwide are reported at 84-97%. Results are related to stricture complexity and surgical experience. There is still no consensus on success parameters. Urethroplasty presents less recurrence compared with direct visual internal urethrotomy, promoting long-term quality of life

Uretroplastia término-terminal para el tratamiento primario de la estenosis de uretra: experiencia del Hospital General Dr. Manuel Gea González