DOI: http://dx.doi.org/10.18203/2349-2902.isj20191130

Role of intermittent self catheterization in prevention of recurrence of stricture urethra following visual internal urethrotomy: a prospective single centre study

Vijaya Kumar R., Sachin Dharwadkar, Chirag Doshi, Akshey Batta

Abstract


Background: Stricture urethra is a highly recurrent disease. Various treatment modalities were used to prevent its recurrence post urethrotomy with variable success. The objective of this randomized study was to compare the stricture recurrence after optical internal urethrotomy with and without clean intermittent self catheterization in patients with anterior urethral stricture.

Methods: A total of fourty patients aging 20-60 years with urethral stricture of up to 1cm and up to six months duration were selected randomly in to treatment group A (20 patients) control group B (20patients) and all patients were treated with VIU followed with indwelling catheter for 7 days. Patients with traumatic urethral stricture, congenital or malignant strictures were excluded. The treatment group A was taught to perform self clean intermittent catheterization by inserting Nelaton catheter. All patients were followed regularly at 3,6,12 months.

Results: 4 (20%) patients in treatment group A had stricture recurrence while 15 (75%) out of 20 patients in control group B developed urethral stricture recurrence. In Group A 2 Patient developed stricture in first 6 months and 2 in next 6 months of follow up while in control group B 10 patients (50%)out of 20 had their recurrence in the first six months of follow-up while 5 (25%) in group B had their recurrence in the next six months of follow-up.

Conclusions: Clean self intermittent catheterization is a simple, safe, cost effective and easy to perform procedure for prevention of urethral stricture with good acceptability and compliance.


Keywords


Stricture urethra, Clean intermittent self catheterization, Prevention of urethral strictures

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References


Shaw TJ, Kishi K, Mori R. Wound associated skin fibrosis: mechanism and treatment based on modulating the inflammatory response. Endocr Metab Immune Disord Durg Targets. 2010;10(4):320-30.

Mundy AR. Management of Urethral Strictures. Postgrad Med J. 2006;82(970):489-93.

Fenton AS, Morey AF, Aviles R, Garcia CR. Anterior urethralstrictures: aetiology and characteristics. Urology. 2005;65:1055-8.

Lawrence WT, MacDonagh RP. Treatment ofurethral stricture disease by internal urethrotomy followed by ‘low friction’ self-catheterisation: preliminary report. J R Soc Med. 1988;81:136–9.

Mathur M, Nayak D, Aggarwal G, Shukla A, KhanF, Odiya S. A retrospective analysis of urethralstrictures and their management at a tertiary carecenter. Nephro Urol Mon. 2011;3(2):109-13.

Steenkamp JW, Heyns CF, de Kock ML. Internal urethrotomyversus dilatation as treatment for male urethral strictures: aprospective randomized comparison. J Urol. 1997;157:98-101.

Khan S, Khan RA, Ullah A, ul Haq F, RahmanA, Durrani SN, et al. Role of clean intermittentself catheterisation (CISC) in the prevention ofrecurrent urethral strictures after internal opticalurethrotomy. J Ayub Med Coll Abbottabad. 2011;23(2):22-5.

Mazdak H, Meshki I, Ghassami F. Effect of mitomycin C on anterior urethral stricture reocurrence after internal urethrotomy. Eur Urol. 2007;51:1089-92.

Kjrergaard B, Walter S, Bartholin J, Andersen JT,Nøhr S, Beck H, et al. Prevention of urethral stricturerecurrence using clean intermittent self-catheterisation. Br J Urol. 1994;73:692–5.

Gelman J, Liss MA, Cinman NM. Direct vision Balloon Dilatation for the management of urethral strictures. J Endoural. 2011;25(8):1248-51.

Roosen JU. Self-catheterisation after urethrotomy: Prevention of urethral stricture recurrence using clean intermittent selfcatheterisation. Urol Int’l. 1993;50:90-2.

Lauritzen M, Greis G, Sandberg A, Wedren H, Ojdeby G, Henningsohn L. Intermittent self-dilatation after internal urethrotomy for primary urethral strictures: A case-control study. Scand J Urol Nephrol. 2009;43:220-5.