Outcome of intralesional mitomycin c with optical internal urethrotomy and optical internal urethrotomy with clean intermittent self-catheterization in the treatment of bulbar urethral stricture

Abstract

Urethral stricture is one of the oldest known urological diseases and remains a common problem with high morbidity. The most common kind of management for urethral stricture is optical internal urethrotomy (OIU) which is a minimally invasive procedure with lower morbidity. But there is a common postoperative complication after OIU, recurrence of stricture. To prevent this, several methods have been added with this therapeutic option like, injecting intralesional mitomycin C (MMC) or steroid at stricture site, practicing clean intermittent self- catheterization (CISC). To compare the outcome between intralesional MMC with OIU and OIU with CISC in the treatment of bulbar urethral stricture. This was a quasi-experimental study conducted in the Department of Urology, Sir Salimullah Medical College Mitford Hospital, carried out during April 2022 to September 2023. A total of 50 adult male patients with bulbar urethral stricture (up to 1.5 cm) were purposively selected for the study. Patients were grouped into Group-A (n=25, prior intralesional of 0.1% MMC and OIU) and group-B (n=25, both OIU and CISC) with alternate assignment. Two of 25 patients in group A and three of 25 patients in group B lost to follow up. Hence total of forty five patients completed the study. Follow ups were done at 7th post-operative day, 3rd month, 6th month and 12th month. Data analysis was done by SPSS version 25. Demographic characteristics were similar across the two groups in terms of age, residence, occupation (p≥0.05). No significant difference was noted in baseline length of stricture, maximum urine flow rate, and post voidal residual volume (p≥0.05). At postoperative 3rd, 6th and 12th month follow up, post-operative Qmax was statistically higher (p