Abstract
Background: To evaluate durability of DVIU results and recurrence of stricture if the CSIC was done regularly up to one year and weekly thereafter. Subjects and Methods: This retrospective study was conducted in the Department of Urology at tertiary care teaching hospital of Rajasthan, India. Files of all patients operated between January 2015 and July 2018 for single bulbar urethral strictures of less than 1-1.5cm size in length, iatrogenic, idiopathic, traumatic or inflammatory origins were evaluated. Patient with multiple or complicated strictures of post urethroplasty, post hypospadias repair, previous radiation or multiple DVIU were excluded from the study. Data of all patients who were on CSIC following direct vision internal urethrotomy were evaluated at 3, 6, 12 and 24 months. Results: Mean age of patients was 41.13 years with range in between 26-74 years. Most common cause of urethral strictures were idiopathic 66 (58.92%) followed by iatrogenic 27 (24.11%) causes. After 24 months of follow up 95 (84.82%) patients maintained urethral caliber up to 16 Fr. Failure or recurrence was found in 17 (15.18%) patients who required intervention. Conclusion: Direct vision internal urethrotomy (DVIU) with regular clean intermittent self-catheterization (CSIC) was found good success rate in bulbar urethral strictures upto 1 cm in selected patients.
Highlights
Anterior urethral stricture refers to scarring of corpus spongiosum which result in narrowing of urethral lumen
[5] Lawrence and McDonagh have concluded that low friction self-catheterization after direct vision internal urethrotomy (DVIU) is very satisfactory method of managing patients with recurrent strictures. [6,7] Kjaegarrd et al have studied 55 patients and concludes that weekly clean self-intermittent catheterization (CSIC) is a simple method of reducing recurrence of strictures after DVIU. [8]
Patient with multiple or complicated strictures of post urethroplasty, post hypospadias repair, previous radiation or multiple DVIU were excluded from the study
Summary
Anterior urethral stricture refers to scarring of corpus spongiosum which result in narrowing of urethral lumen. DVIU and dilatation are most commonly performed minimal invasive procedure for urethral strictures because of its advantages of simplicity, low cost, minimal complications, short hospitalization and recovery time. Dilatation has high recurrence rates whereas urethroplasty surgery is complex, demanding good surgical skills, high cost and with long recovery time. [5] Lawrence and McDonagh have concluded that low friction self-catheterization after DVIU is very satisfactory method of managing patients with recurrent strictures. [6,7] Kjaegarrd et al have studied 55 patients and concludes that weekly CSIC is a simple method of reducing recurrence of strictures after DVIU. This study was planned to evaluate durability of DVIU results and recurrence of stricture if the CSIC was done regularly up to one year and weekly thereafter
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