™ Extravasation of irrigation fluid or urine with consecutive infection. ™ Penile or scrotal edema may occur but is usually reabsorbed within 1-2 days. ™ Urethral perforation and via falsa. ™ Urethral fistula. ™ Urethral diverticulum. ™ Injury to the corpora cavernosa. ™ Injury to the striated external sphincter with subsequent incontinence. ™ Erectile dysfunction by direct injury to cavernosal nerves, local infection or shunt formation between corpora cavernosa and corpus spongiosum.
Careful technique, irrigation with isotonic solution and strict observance of purulent urethritis or urethral abscess as a contraindication generally result in a low complication rate. Profuse hemorrhage is usually controlled by the passage of a 24-Fr catheter, occasionally in combination with a penile pressure dressing.
™ Each urethrotomy produces new scars of different extension, which forms the base for recurrent strictures.
The recurrence rate after internal urethrotomy is up to 60%. About half of the recurrences develop during the first postoperative year. Since the third urethrotomy leads to a further recurrence of stenosis in nearly 100%, two attempts of ure-throtomy should be the limit. If the obstructive symptoms recur rapidly, open surgical treatment should be considered.
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