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CC BY-NC-ND 4.0 · Revista Urología Colombiana / Colombian Urology Journal 2021; 30(01): 066-073
DOI: 10.1055/s-0040-1722237
Review Article | Artículo de Revisión
Reconstructive Urology | Urología reconstructiva

Factores de riesgo y estrategias de prevención para el desarrollo de estrechez uretral de origen iatrogénico: Papel del urólogo

Risk Factors and Prevention Strategies for the Development of Urethral Stricture of Iatrogenic Origin: Role of the Urologist
Andres Goméz Hoyos 
1   Urólogo, Universidad CES, Medellín, Colombia.
,
Federico Gaviria Gil
1   Urólogo, Universidad CES, Medellín, Colombia.
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Resumen

La estrechez uretral constituye una patología con morbilidad importante en el sexo masculino. Se evidencia en la actualidad un cambio en la frecuencia de las etiologías, con la disminución de causas inflamatorias y una transición hacia la iatrogenia como la más común. Mediante la búsqueda del estado del arte en cuanto a los procedimientos diagnósticos y terapéuticos conocidos como factores asociados a la estrechez uretral iatrogénica, se realizó una revisión narrativa de la literatura con el fin de describir y generar estrategias para su prevención. De los procedimientos terapéuticos que originan la estrechez uretral como complicación, el sondaje vesical es la mayor causa (hasta 34,3%), seguido de la prostatectomía radical (29,9%). Una buena técnica de sondaje vesical orientada desde el adecuado entrenamiento del personal disminuye de forma considerable su incidencia. Por otra parte, la adecuada selección de tratamientos y aspectos técnicos en pacientes que requieren el manejo de patologías obstructivas del tracto urinario como la hiperplasia prostática y litiasis u oncológicas como el cáncer de próstata, son unas de las recomendaciones para la prevención de ese trastorno. El entendimiento de los factores de riesgo y la adherencia a las estrategias de prevención descritas buscan disminuir la incidencia de la estrechez uretral de origen iatrogénico.

Abstract

Urethral stricture is a pathology with significant morbidity in men. There is current evidence of a change in the prevalence of etiologies, with a decrease in inflammatory causes and a transition towards iatrogenesis as the most frequent. Through the search for the state of art in terms of diagnostic and therapeutic procedures known as associated factors to iatrogenic urethral stricture, a narrative review has been performed, in order to describe and recommend strategies for its prevention. Of the therapeutic procedures that cause urethral stricture as a complication, bladder catheterization is the main (up to 34.3%), followed by radical prostatectomy (29.9%). A good bladder catheterization technique guided by adequate training of personnel considerably reduces its incidence. On the other hand, the proper selection of treatments and technical aspects in patients who require the management of obstructive pathologies of the urinary tract such as prostatic hyperplasia and lithiasis or oncological diseases such as prostate cancer, are some of the recommendations for the prevention of this disorder. Understanding risk factors and adherence to the prevention strategies described seek to reduce the incidence of iatrogenic urethral stricture.

Palabras clave

estrechez uretral - procedimientos quirúrgicos urológicos - cateterismo urinario - cistoscopia - enfermedad iatrogénica

Keywords

urethral stricture - urologic surgical procedures - urinary catheterization - cystoscopy - iatrogenic disease


Publication History

Received: 28 August 2020

Accepted: 17 November 2020

Article published online:
15 March 2021

© 2021. Sociedad Colombiana de Urología. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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