To Compare the Recurrence Rate of Strictures after Internal Optical Urethrotomy with Intralesional Injection of Mitomycin C versus without Mitomycin C Injection in Patients Presenting with Anterior Urethral Stricture
Ismat Ullah, Muhammad Waqar Shahid, Muhammad Azeem Mughal, Rahat Usman
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ABSTRACT
Background: The urethral strictures occurred due to
narrowing of urethra. These may occur after an injury or ureteral or excretory
system diseases, due to the injury to urothelium or corpus spongiosum that lead
to the development of scar tissues. Mitomycin C can be used as chemotherapeutic
agent because of its quality of being anti-tumour actions.
Aim: To compare the recurrence rate of strictures after
internal optical urethrotomy with intralesional injection of Mitomycin C versus
without Mitomycin C injection in patients presenting with anterior urethral
stricture.
Study Design: Randomized controlled trial.
Place and Duration of Study:
Department of Urology, Lahore General Hospital, Lahore from 5th
September 2016 to 5th March 2017.
Methodology: Sixty male patients age 18-70 years,
diagnosed with anterior (penile and bulbar) urethral stricture up to 2.0cm were
included. Patients were randomly
divided into two groups; Group A patients were treated with internal optical
urethrotomy alone and Group B patients treated with internal optical
urethrotomy with intralesional injection of Mitomycin C. After the procedure,
an 18F or 20F indwelling catheter left for 7 days. After 6 months, surgical
site evaluated and if stricture again developed, then recurrence labeled.
Results: The mean age was 39.32±11.38 years, mean
duration of stricture was 6.85±3.32 months and the mean stricture size was
1.21±0.45 cm. The recurrence occurred in 18 (30%) patients. Significant
difference was noted for recurrence in both groups (p-value<0.05).
Conclusion: The recurrence rate with anterior urethral
stricture is significantly lower in with Mitomycin C as compared to without
Mitomycin C.
Keywords: Recurrence, Urethral stricture, Mitomycin C