COMPARISON OF RECURRENCE OF URETHRAL STRICTURE AFTER INTERNAL OPTICAL URETHROTOMY WITH AND WITHOUT POST-OPERATIVE ORAL STEROIDS IN DISTRICT DERA ISMAIL KHAN
DOI:
https://doi.org/10.54112/bcsrj.v2023i1.240Keywords:
Urethral stricture;, Adult population, ; oral steroids;, internal optical urethrotomyAbstract
Urethral stricture is one of the most common diseases in urology. The urethral structure is the narrowing of the urethral lumen due to spongiofibrosis. It is notorious for its recurrence and accounts for the major burden on the Urology department. Internal optical urethrotomy is considered the first line of treatment for urethral stricture. When combined with clean intermittent self-catheterization, and Intralesional injections, better results could be obtained. This study compares the recurrence of urethral stricture after internal optical urethrotomy with and without post-operative oral steroids in the population of Dera Ismail Khan. The study was a non-randomized control trial done in the Urology Department, DHQ/MTI-TH, Dera Ismail Khan, Pakistan, from January 2021 to June 2021. The patients from the urology outdoor and emergency of DHQ Teaching Hospital were included in the study. A total of 152 patients were divided by lottery method into two groups’ an experimental group and Control group, each containing 76 patients. After losing follow-up, the remaining patients who completed the study were 128. The patients in both groups underwent internal optical urethrotomy with a cold knife. The experimental group of patients received oral steroids for 4 weeks. The control group didn’t receive steroids after the procedure. The mean age in the experimental group was 41 ± 09 years, while in the control group, it was 36 ± 13 years. After 6 months, the recurrence was observed in 12 patients (18.75%) in the experimental group and 25 in the control group (39.06%). These results showed a statistically significant difference in recurrence rate between these two groups with a p-value of 0.0123. Based on the results, it can be concluded that the use of oral steroids after internal optical urethrotomy decreases the risk of recurrence of urethral stricture significantly.
Downloads
References
Ali, L., Shahzad, M., Orakzai, N., Khan, I., and Ahmad, M. (2015). Efficacy of mitomycin C in reducing recurrence of anterior urethral stricture after internal optical urethrotomy. Korean Journal of Urology 56, 650-655.
Bullock, T. L., and Brandes, S. B. (2007). Adult anterior urethral strictures: a national practice patterns survey of board certified urologists in the United States. The Journal of urology 177, 685-690.
Chhetri, R., Shrestha, G., Joshi, H., and Shrestha, R. (2009). Management of urethral strictures and their outcome. Nepal Med Coll J 11, 5-8.
Dahl, C., and Hansen, R. (1986). Optical internal urethrotomy with and without catheter. A comparative study. In "Annales Chirurgiae et Gynaecologiae", Vol. 75, pp. 283-284.
Dutkiewicz, S. A., and Wroblewski, M. (2012). Comparison of treatment results between holmium laser endourethrotomy and optical internal urethrotomy for urethral stricture. International urology and nephrology 44, 717-724.
Ergün, O., Güzel, A., Armağan, A., Koşar, A., and Ergün, A. G. (2015). A prospective, randomized trial to evaluate the efficacy of clean intermittent catheterization versus triamcinolone ointment and contractubex ointment of catheter following internal urethrotomy: long-term results. International Urology and Nephrology 47, 909-913.
Govindaraju, S., and Ettappan, A. (2018). A COMPARATIVE STUDY OF OPTICAL INTERNAL URETHROTOMY ALONE WITH OPTICAL INTERNAL URETHROTOMY PLUS STEROID FOR ANTERIOR URETHRAL STRICTURE DISEASE. Journal of Evolution of Medical and Dental Sciences 7, 2834-2838.
Gupta, S., Roy, S., and Pal, D. K. (2018). Efficacy of oral steroids after optical internal urethrotomy in reducing recurrence of urethral strictures. Turkish journal of urology 44, 42.
Jhanwar, A., Kumar, M., Sankhwar, S. N., and Prakash, G. (2016). Holmium laser vs. conventional (cold knife) direct visual internal urethrotomy for short-segment bulbar urethral stricture: Outcome analysis. Canadian Urological Association Journal 10, E161.
Khan, S., Khan, R., and Ullah, A. (2011). ul Haq F, ur Rahman A, Durrani SN, et al. Role of clean intermittent self catheterisation (CISC) in the prevention of recurrent urethral strictures after internal optical urethrotomy. J Ayub Med Coll Abbottabad 23, 22-5.
Kumar, S., Garg, N., Singh, S. K., and Mandal, A. K. (2014). Efficacy of optical internal urethrotomy and intralesional injection of Vatsala-Santosh PGI tri-inject (triamcinolone, mitomycin C, and hyaluronidase) in the treatment of anterior urethral stricture. Advances in Urology 2014.
Siregar, S., Parardya, A., Sibarani, J., Romdan, T., Adi, K., Hernowo, B. S., and Yantisetiasti, A. (2017). AT1 expression in human urethral stricture tissue. Research and Reports in Urology, 181-186.
Tabassi, K. T., Yarmohamadi, A., and Mohammadi, S. (2011). Triamcinolone injection following internal urethrotomy for treatment of urethral stricture. Urology Journal 8, 132-136.
van Leeuwen, M. A., Brandenburg, J. J., Kok, E. T., Vijverberg, P. L., and Bosch, J. R. (2011). Management of adult anterior urethral stricture disease: nationwide survey among urologists in the Netherlands. European urology 60, 159-166.
Zar, J. H. (1999). "Biostatistical analysis," Pearson Education India.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 M ILYAS, M SEERWAN, M ADNAN, A NASEEM, N JAVED, M HUSSAIN
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.