Absence of urethral strictures with suprapubic urinary drainage during extracorporeal circulation.

Postoperative urethral strictures following extracorporeal circulation in open heart surgery are not uncommon. The etiology is not clear. Ischemia and pressure of the Foley catheter may cause a lesion that eventually leads to urethral stricture. We retrospectively analyzed 300 patients who had undergone open heart surgery. In 1 group the bladder was drained by a Foley catheter during extracorporeal circulation, while another group underwent suprapubic drainage. Strictures developed in 10 of 152 patients (6.6%) with an indwelling catheter. Conversely, no strictures occurred in the 148 patients treated with suprapubic urinary drainage. The use of suprapubic drainage during extracorporeal circulation greatly decreases the risk of postoperative urethral strictures.