Recurrence of urethral stricture and late results after optical urethrotomy: comparison of strictures caused by toxic latex catheters and other causes.

During the years 1977-1985, 183 new urethral strictures were diagnosed and treated by optical urethrotomy. A sharp increase in the incidence of iatrogenic strictures was found in 1980-1981 which normalized after simultaneous changing of the resectoscope, lubricant and catheter type. In fact, an "epidemic" of urethral strictures associated with the use of indwelling latex catheters in cardiac operations was observed in Finland in those years. It is suggested that toxic latex catheters exacerbated the local mechanical injury caused by endoscopic surgery. The recurrence rate for our "epidemic" strictures was 54%, whereas in other cases it was 37% (p = 0.02), but there were no differences in the later course. The patients age, stricture site, postoperative period of catheter-drainage, length, diameter or multiplicity had no effect on the recurrence rate after the initial urethrotomy. Stricture recurrences occurred up to 8 years after the initial operation. Because of the chronic nature of the urethral stricture, a follow-up time of at least 10 years is needed before the final results of urethrotomy can be evaluated.