A comparative study of catheter size effect after direct vision internal urethrotomy for small urethral strictures

Rohit Ajmera; Piyush Kumar Saini; Keshav Sharma; Rakesh Ramesh Pawar; Rohit Yadav

doi:10.18203/2320-6012.ijrms20244119

Authors

Rohit Ajmera Department of Urology, JLN Medical college Ajmer, Rajasthan, India
Piyush Kumar Saini Department of Urology, JLN Medical college Ajmer, Rajasthan, India
Keshav Sharma Department of Urology, JLN Medical college Ajmer, Rajasthan, India
Rakesh Ramesh Pawar Department of Urology, JLN Medical college Ajmer, Rajasthan, India
Rohit Yadav Department of Urology, JLN Medical college Ajmer, Rajasthan, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20244119

Keywords:

DVIU, Urethral Stricture, Spongiofibrosis, Cystoscopy

Abstract

Background: Urethral stricture disease is the most common cause of obstructive voiding symptoms in younger males and has always been a challenge for urologists. Optical urethrotomy (OU) has been considered as the standard therapy for anterior urethral and short segments strictures.

Methods: In our study 164 consecutive treatment naive and recurrent urethral stricture patients who underwent direct vision internal urethrotomy (DVIU) were retrospectively analyzed. 22Fr urethral catheters were placed for longer durations and small calibre catheters (14 or 16Fr) were preferred for shorter dwell times after DVIU. Catheter dwell times were grouped as <7 and ≥7 days.

Results: A total of 164 patients with a mean age of 54.51±11.8 (range: 17 to 85) years were enrolled in the study during the follow-up, 24 (14.6%) patients experienced recurrences during 6 month follow up. The mean postoperative duration of catheterization was 8.47±2.03 and 6.49±1.14 days, in 6 patients with 14/16 Fr and 18 patients with 20 Fr catheter respectively have recurrence with p=0.00802.5 patients with less than 7 days and 19 patients with >7 days had recurrence with p=0.0019.

Conclusions: Urethral stricture disease is disease of high recurrence. Factors responsible for recurrence of disease after treatment like-etiology, length of stricture, duration /size of catheter, open or endoscopic procedure. putting a small diameter catheter and short duration of catheterization help in reducing recurrence.

Metrics

Metrics Loading ...

References

Wong SS, Aboumarzouk OM, Narahari R, O’Riordan A, Pickard R. Simple urethral dilatation, endoscopic urethrotomy, and urethroplasty for urethral stricture disease in adult men. Cochrane Database Syst Rev. 2012;CD006934.

Rourke KF. The epidemiology, clinical presentation, and economic burden of urethral stricture. In: Brandes, Steven B., Morey, Allen F. eds. Advanced Male Urethral and Genital Reconstructive Surgery New York: Humana Press. 2014;83-93.

Rourke K, Hickle J. The clinical spectrum of the presenting signs and symptoms of anterior urethral stricture: Detailed analysis of a single institutional cohort. Urology. 2012;79:1163-7.

Buckley JC, Heyns C, Gilling P, Carney J. SIU/ICUD Consultation on Urethral Strictures: Dilation, internal urethrotomy, and stent¬ing of male anterior urethral strictures. Urology. 2014;83(3):S18-22.

Sachse H. Treatment of urethral stricture: Transurethral slit in view using sharp section. Fortschr Med. 1974;92:12-5.

De Kock MLS, Allen FJ. Guidelines for the treatment of urethral strictures. S Afr J Surg. 1989;27(5):182.

Sandozi S, Ghazali S. Sachse optical urethrotomy, a modified technique: 6 years of experience. J Urol. 1988;140(5):968.

Matouschek E. Internal urethrotomy of urethral stricture under-vision; a five year report. Urol Res. 1978;6(3):147-50.

Gaches CGC, Ashken MH, Dunn M, Hammonds JC, Jenkins IL, Smith PJ. The role of selective internel urethrotomy in the management of urethral stricture: a multi-centre evaluation. Br J Urol. 1979;51(6):579-83.

Greenland JE, Lynch TH, Wallace DMA. Optical urethrotomy under local urethral anesthesia. Br J Urol. 1998;67(4):385-8.

Ather MH, Zehri AA, Soomro K, Nazir I. The safety and efficacy of optical urethrotomy using a spongiosum block with sedation: a comparative nonrandomized study. J Urol. 2009;181(5):2134-8.

Buckley JC, Heyns C, Gilling P, Carney J. SIU/ICUD Consultation on Urethral Strictures: Dilation, internal urethrotomy, and stent¬ing of male anterior urethral strictures. Urology. 2014;83(3):S18-22.

Bullock TL, Brandes SB. Adult anterior urethral strictures: a na¬tional practice patterns survey of board certified urologists in the United States. J Urol. 2007;177(2):685-90.

Chilton CP, Shah PJ, Fowler CG, Tiptaft RC, Blandy JP. The impact of optical urethrotomy on the management of urethral strictures. Br J Urol. 1983;55(6):705.

Stormont TJ, Suman VJ, Oesterling JE. Newly diagnosed bulbar urethral strictures: etiology and outcome of various treatments. J Urol. 1993;150(5pt2):1725.

Ishigooka M, Tomaru M, Hashimoto T, Sasagawa I, Nakada T, Mitobe K. Recurrence of urethral stricture after single internal urethrotomy. Int Urol Nephrol. 1995;27(1):101.

Pansadoro V, Emiliozzi P. Internal urethrotomy in the manage¬ment of anterior urethral strictures: Long-term follow up. J Urol. 1996;156(1):73-5.

Al-Ali M, Al-Shukry M. Endoscopic repair in 154 cases of urethral occlusion: The promise of guided optical urethral reconstruction. J Urol. 1997;157(1):129-31.

Albers P, Fichtner J, Bruhl P, Müller SC. Long-term results of in¬ternal urethrotomy. J Urol. 1996;156(5):1611-4.