[Congenital bllbar urethral stenosis and its therapy by means of internal urethrotomy under direct vision (according to Sachse) (author's transl)].

Congenital bulbar urethral stenosis arises from incomplete opening of the urogenital membrane. The etiology may possibly be genetic or else a disturbance in the maternal hormones during the embryonic phase. The diagnosis from other types of stenosis is made by urethroscopy. The urodynamic consequences are a compensatory hypertrophy of bladder muscle, in extreme cases finally followed by hydronephrosis. Symptoms of stenosis include dysuria, polyuria, enuresis, and recurrent urinary tract infection. The whole urinary tract should be investigated. At present, the operation of choice for dealing with this type of stenosis, is internal urethrotomy under direct vision (Sachse's operation). Short-term indwelling catheterization, prophylaxis against infection, and hydraulic auto-bougination (raising the internal urethral pressure by compressing the penis during micturition) help to ensure success. The percentage of complications is low. The risk of recurrence is less than with the use of electrocautery.