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Volume 7 Issue 11 (November, 2019)

Original Articles

Internal Urethrotomy for Anterior Urethral Strictures, its Place in the Current Management of Stricture Disease and Role of C.S.I.C in Prevention of Recurrence
Akhilesh Chandra, Surya Kumar Singh

Background: Simple urethral dilatation (sequential) and, DVIU have been used for long time for the ease and simplicity of the procedure and low morbidity for anterior Urethral strictures (Bulbar and Penile). The present study was done to assess the role of DVIU (Direct Vision Internal Urethrotomy). Its success and failure including recurrence of stricture disease and role of Clean Self-Intermittent Catheterization (CSIC) following DVIU. Materials and Methods: The present study was done on 265 patients, between 2014 to 2019, retrospective uncontrolled study at Balrampur Hospital, Lucknow. Characteristics such as cause, location, length of stricture, recurrent stricture disease free period following repeat DVIU were recorded. USG, RGU/MCU, Cystourethroscopy apart from AUA symptom index and PROM (Patient reported outcome measure.) were taken into consideration Role of CSIC was evaluated. Results: Out of 266 patients of anterior urethral stricture who underwent DVIU overall success rate (one year follow up) was 54%, short bulbar stricture less than 2cm gave best results with recurrence rate of only 25%. We could find identifiable cause only in 122 out of 266 patients, hence maximum being idiopathic 54.1% (144 patients) followed by Inflammatory 19.5% (52 patients). Success rate was best in inflammatory strictures 74% followed by Idiopathic stricture 55% and worst prognosis was that for recurrent strictures 28%. CSIC improves the outcome significantly with success rate of 73% in pts practicing CSIC as compared to 27% for those who were inconsistent or defaulted. Conclusion: DVIU is best for short bulbar stricture and has poor outcome for recurrent strctures. CSIC enhances success rate significantly.

 
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