The use of a ureteral access sheath for the urethral dilatation and catheterization of difficult urethral strictures.

BACKGROUND

Urethral catheterization can often be technically demanding due to the presence of obstructing segments within the urethra. Conventional methods attempting to restore urethral patency often are unsuccessful and traumatize the urethral lumen.

METHOD

We present an innovative technique by using a hydrophilic guidewire and a hydrophilic ureteral access sheath for the 'first-line' catheterization and management of 'difficult' urethral strictures. We used this technique in 10 extremely difficult cases of strictures present in all the urethral segments.

RESULT

The dilation was successful and atraumatic in all the cases due to the hydrophilic nature of the access sheath. In all patients, larger sizes of urethral catheters were gradually inserted within the next couple of days.

CONCLUSION

We propose 'access sheath'-assisted urethral dilatation as a safe and simple alternative for the 'first-line' catheterization and, possibly, management of 'difficult' urethral strictures.