Outcome of Internal Optical Urethrotomy in Combination with Corticosteroids Injection in Recurrent Anterior Urethral Strictures

Abstract

Background: Urethral stricture is a common urological disease and can occur mostly as a result of recurrent infections, inflammation, trauma or unknown factors. Internal optical urethrotomy is a useful treatment modality for the management of urethral strictures. Several adjuvant interventions are suggested to decrease the recurrence rate of urethral strictures. Objectives: To report the success rate of internal optical urethrotomy in combination with corticosteroids in recurrent anterior urethral strictures. Materials and Methods: This prospective clinical randomized control trial was performed on 70 patients from 1st January 2017 to 31st Dec 2018. Patients fulfilling the inclusion criterion were randomly divided into two groups. The experimental group comprises 34 patients who received a corticosteroid injection in combination with internal optical urethrotomy while the control group consisting of 36 patients who received distilled water in combination with internal optical urethrotomy. All the patients were advised not to do clean intermittent self-catheterization (CISC) and were followed for 24 months. Results: The mean follow-up time was 9 ± 5.40 months (6-24 months). Complications occurred in 14 patients. In the experimental group recurrence of stricture occurred in 11 patients, extravasation into perispongeal space in 3 patients (8.82%), infection in 1(2.94%) and bleeding in 2(5.8%) patients. In the control group recurrence of stricture occurred in 16 patients, Infection occurred in 3 patients and extravasation and bleedings in 2 and 3 patients respectively. Moreover, the difference between the recurrence in the experimental and control groups is also not significant (p.0.05). However, the stricture-free duration that is the time of recurrence was significantly delayed in the experimental group (8.07 ± 5.51 versus 3.8 ± 1.53 months). Conclusion: It is concluded that internal optical urethrotomy in combination with corticosteroid injection delays the recurrence rate of urethral stricture significantly. It can also be a feasible procedure for those who do not want urethroplasty or those with high risk for general anesthesia.