The Meatal Problem with TUR Prostate: the Value of Post ‐ operative Self ‐ dilatation

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Abstract
Summary— In a preliminary retrospective study, we found that 37% of patients about to undergo a transurethral resection of the prostate had an external meatus too small to admit a 26 F resectoscope sheath.In a prospective study, a formal meatotomy was compared with an Otis urethrotomy for patients with narrow meatus. This study was stopped because 71% of cases having a meatotomy developed strictures compared with 29% having an internal urethrotomy.In a further study of 59 patients, regular self ‐ dilatation of the meatus with a plastic spigot was compared with internal urethrotomy of the meatus alone. Seven per cent of cases having self ‐ dilatation developed strictures compared with 34% having internal urethrotomy.It was concluded that in those patients with a narrow external meatus meatotomy should not be carried out, but self ‐ dilatation following internal urethrotomy greatly reduces the incidence of meatal strictures.