Urethral Steinstrasse Mimicking Panurethral Stricture: A Case Series.

Abstract

Introduction: Urethral stricture is a common cause of bladder outlet obstruction and secondary urethral stones. Rarely these stones may pile up in the urethra and exaggerate the existing stricture. Careful examination of the urethrogram and urethroscopy will accurately identify these stones. Case series: We present 2 cases of urethral strictures which were preoperatively diagnosed as pan-urethral stricture due to impaction of long column of urethral stones. The first one was identified intra-operatively while the second one was detected preoperatively on meticulous examination of the urethrogram. The first patient had extraction of the stones via ventral urethrotomy and dorsal inlay buccal mucosa urethroplasty was done as described by Asopa. The second patient had ventral urethrotomy and extraction of stones, excision of a urethral diverticulum and dorsal inlay buccal mucosa urethroplasty. They had uneventful recovery and voiding normally at present. Conclusion: Urethral Steinstrasse may exaggerate length of urethral stricture, thus mimicking pan- urethral stricture. High index of suspicion, meticulous examination of the urethrogram and urethroscopy will help accurate diagnosis. This will guide choice of appropriate form of urethroplasty preoperatively. Routine urethroscopy in doubtful cases is helpful and advocated.