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Original Research

Efficacy of Optical Internal Urethrotomy with Intermittent Self Dilatation for Urethral Stricture: A Randomized Prospective Study


1 Saglik Bilimleri University, Samsun Training and Research Hospital,  Department of Urology, Samsun, Turkey

2 Sağlık Bilimleri Üniversitesi, Samsun Eğitim ve Araştırma Hastanesi, Üroloji Kliniği, Samsun, Türkiye


DOI :
New J Urol. 2018; 13 (2): 06-13

Abstract

Objectives: Urethral stricture is a com-monly seen clinical entity in adult men that is mostly seen due to secondary causes. Optical internal urethrotomy (OIU), urethral dilata-tion and open urethroplasty are therapeutic options for strictures. It is still controversial whether intermittent self-dilatation is a good option for urethral stricture treatment.

Aims: We assessed the effectivity of self-dilatation on urethral stricture recur-rence.

Material and Methods: The effectivity of self-dilatation was assessed prospectively in two groups of patients; 67 of these patients performed self dilatation twice a week after optical internal urethrotomy (study group), and 63 did not (control group). The primary outcome was to assess improvement in the maximum urine flow rate (Qmax), while the secondary outcome was to monitor the In-ternational Erectile Function Index, Inter-national Prostate Symptom Score, Quality of Life score, postvoiding residual urine volume, urinary infection, and other uroflowmetric parameters.

Results: In the first postoperative control, the mean Qmax were 14±3 mL/s and 14.3±2.4 mL/s in control group and study group, re-spectively (p=0.44). The third postopera-tive control revealed, the mean Qmax were11.6±2.9 mL/s and 9.2±1.8 mL/s in control group and study group, respectively (p=0.01) whereas IIEF scores were similar (p=0.63). In the sixth month control revealed, the mean Qmax were 9.2±2.4 mL/s and 12.2±1.8 mL/s, respectively (p=0.34). QoL, and IIEF val-ues were not statistically different (p>0.05).

Conclusion: Although self dilatation after optical internal ure-throtomy is an easily and commonly applied method with minor side effects, it does not help to prevent short-term urethral stricture and does not lengthen recurrence intervals.

Keywords: Internal Urethrotomy, Self-Dilatation, Urethral Stricture


Abstract

Objectives: Urethral stricture is a com-monly seen clinical entity in adult men that is mostly seen due to secondary causes. Optical internal urethrotomy (OIU), urethral dilata-tion and open urethroplasty are therapeutic options for strictures. It is still controversial whether intermittent self-dilatation is a good option for urethral stricture treatment.

Aims: We assessed the effectivity of self-dilatation on urethral stricture recur-rence.

Material and Methods: The effectivity of self-dilatation was assessed prospectively in two groups of patients; 67 of these patients performed self dilatation twice a week after optical internal urethrotomy (study group), and 63 did not (control group). The primary outcome was to assess improvement in the maximum urine flow rate (Qmax), while the secondary outcome was to monitor the In-ternational Erectile Function Index, Inter-national Prostate Symptom Score, Quality of Life score, postvoiding residual urine volume, urinary infection, and other uroflowmetric parameters.

Results: In the first postoperative control, the mean Qmax were 14±3 mL/s and 14.3±2.4 mL/s in control group and study group, re-spectively (p=0.44). The third postopera-tive control revealed, the mean Qmax were11.6±2.9 mL/s and 9.2±1.8 mL/s in control group and study group, respectively (p=0.01) whereas IIEF scores were similar (p=0.63). In the sixth month control revealed, the mean Qmax were 9.2±2.4 mL/s and 12.2±1.8 mL/s, respectively (p=0.34). QoL, and IIEF val-ues were not statistically different (p>0.05).

Conclusion: Although self dilatation after optical internal ure-throtomy is an easily and commonly applied method with minor side effects, it does not help to prevent short-term urethral stricture and does not lengthen recurrence intervals.

Keywords: Internal Urethrotomy, Self-Dilatation, Urethral Stricture

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