DOI: 10.29188/2222-8543-2026-19-2-112-119
For citation:
Muzhaylov A.O., Kyzlasov P.S., Dutov S.V., Martov A.G. Comparative outcomes of optical internal urethrotomy supplemented with the Otis urethrotomy versus augmentation urethroplasty in the treatment of long anterior urethral strictures. Experimental and Clinical Urology. 2026;19(2):112-119; https://doi.org/10.29188/2222-8543-2026-19-2-112-119
Muzhaylov A.O., Kyzlasov P.S., Dutov S.V., Martov A.G.
Information about authors:
- Muzhaylov A.O. – PhD student of the Department of urology and andrology of Medical and Biological University of Innovation and Continuing Education of the State Scientific Center – A.I. Burnazyan Federal Medical Biophysical Center of the Federal Medical and Biological Agency of Russia, Moscow, Russia; https://orcid.org/0009-0006-8837-7284
- Kyzlasov P.S. – Dr. Sci., Professor of the Department of urology and andrology of Medical and Biological University of Innovation and Continuing Education of the State Scientific Center – A.I. Burnazyan Federal Medical Biophysical Center of the Federal Medical and Biological Agency of Russia, head of the Center of urology and andrology of A.I. Burnazyan Federal Medical Biophysical Center of the Federal Medical and Biological Agency of Russia, Moscow, Russia; RCSI Author ID: 615093, https://orcid.org/0000-0003-1050-6198
- Dutov S.V. – PhD, Associate Professor of the Department of urology and andrology of Medical and Biological University of Innovation and Continuing Education of the State Scientific Center – A.I. Burnazyan Federal Medical Biophysical Center of the Federal Medical and Biological Agency of Russia; urologist of the Urology department of the Urology center of Central clinical hospital of civil aviation, Moscow, Russia; RCSI Author ID: 722683, https://orcid.org/0000-0002-5384-355X
- Martov A.G. – Dr. Sci., Professor, corresponding member of the RAS, head of the Department of urology and andrology of Medical and biological university of innovation and continuing education of the State Scientific Center – A.I. Burnazyan Federal Medical Biophysical Center of the Federal Medical and Biological Agency of Russia, Head of the Urology center of Central clinical hospital of civil aviation, Moscow, Russia; RCSI Author ID: 788667, https://orcid.org/0000-0001-6324-6110
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Introduction. Treatment of long anterior urethral strictures remains an urgent problem in modern urology. Augmentative urethroplasty is the standard method of reconstruction, but open surgery is more traumatic and has a longer rehabilitation period. Therefore, interest in minimally invasive methods remains.
Objective. To evaluate the efficacy and safety of optical internal urethrotomy in combination with Otis urethrotomy compared to augmentation urethroplasty in patients with long (more than 4 cm) anterior urethral strictures.
Materials and methods. The study included 68 patients who underwent surgery between October 2022 and April 2025. Thirty-eight patients underwent internal urethrotomy with Otis surgery, and 30 underwent augmentation urethroplasty. The duration of surgery, length of hospital stay, complications and recurrences rates, as well as Qmax, IPSS, QoL, and IIEF-5 scores were evaluated. The follow-up period was up to 24 months.
Results. The duration of the surgery was shorter in the direct visual internal urethrotomy with Otis surgery group: 25.3±5.2 vs 98.1±19.7 minutes (p<0.001). The length of hospital stay was also shorter: 2.1±1.4 vs 3.9±1.2 days (p<0.001). The complication rate did not differ significantly: 10.5% and 13.3%, respectively (p=0.72). In 24 months after internal urethrotomy with Otis surgery, recurrence was detected in 13 (34.2%) patients. After augmentation urethroplasty, recurrence was found in 5 (16.7%) patients (p=0.103). Persistent deterioration of erectile function was noted in 18.2% and 33.3% of sexually active patients, respectively (p=0.438).
Conclusion. Optical internal urethrotomy combined with Otis urethrotomy associates with less morbidity, comparable early complications rate, but it has higher relapses rate compared with augmentation urethroplasty. This technique can be considered a compromise, minimally invasive, step-by-step approach for carefully selected patients with a pre-arranged option to switch to urethroplasty in case of relapse.
