Dear Mohamed
Many patients suffer from urethral stricture after hypospadias repair. Even if it were not symptomatic, narrowing of urethral lumen can cause proximal dilatation (diverticulum), thinning the neourethra and eventually causing a hole (fistula). Therefore, the role of urethral dilation (*not dilatation) is not only widening the stricture site but also preventing further complications (diverticulum or stricture).
actually i am not agree for this concept, there is no role for dilatation of urethra after repair of hypospadias as urethral dilatation causes cracks in the urethral wall with extravasation which causes more fibrosis and more stricture. the best to avoid urethral narrowing is to use large caliber catheter during repair and mid glans suture during repair of hypospadias to avoid narrowing of urethral meatus and urethral diverticulum only noticed with the use of only flap for repair without trimming.
I am agree with Mohamed Aldahshoury comment. we need a wide neourethra with tension free anastomosis and prevention of infection and fibrosis formation.Only in cases of postoperative stricture urethral dilatation may be helpful.
dear Sadrollah
nice but if you will dilate stricture what is the benefit in a child with stricture he is starting his life how comes?? and actually the neourethra is just only epithelial or skin tube had no wall of spongiosal tissue so just you will stretch skin!!!!! and the best for post hypospadias stricture is repair with either dorsal inlay buccal mucosa or skin graft but rarely skin flap as all the penile skin was consumed in repair as you know
nice dr Ricardo i agree but what is the criteria of the stricture that you will dilate after hypospadias repair!!!!! in my mind no role of posthypospadias dilatation at all as stricture is long and how child start his life with frequent dilatations you will stretch only narrow tube formed of skin.
Although dilation post TIP urethroplasty is a frequent and common procedure, it often fail managing stenosis...
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