PROGNOSIS - STRICTURE.
This involves two conditions : First, its curability, and second, its danger to life. The possibility of a radical cure is disputed by the majority of surgeons, the general opinion being that a stricture once formed is never cured. It is, nevertheless, the writer's opinion that a properly performed urethrotomy is usually curative of strictures in the anterior portion of the canal. Deeper strictures are more difficult to cure, but even here thorough operation may be followed by permanent relief. When a stricture does not recontract to a greater or less degree within six months or a year after the cessation of treatment, the prospect of a permanent cure is always fairly good. Recurrence after urethrotomy takes place mucli more readily in ca chectic, strumous, gouty, rheumatic, and syphilitic patients than in those who are healthy. Even when dilatation has been successfully
practised, the patient may remain practically free from a recurrence of his stricture, provided a sound be passed at regular intervals.
The prognosis of stricture as regards its danger to life varies ac cording to the duration of the disease, the severity of its complica tions and sequelm, and the method of treatment. The most impor tant factor is the condition of the kidneys. Impairment of structure and function of these organs is to be inferred in all cases of organic stricture of long standing. Such pathological aberrations of the kid ney are not only immediately dangerous to life, but render all surgi cal measures of treatment more or less dangerous. Renal changes are usually responsible for the fatal result which ultimately occurs in neglected cases of severe stricture.