Abstract
OBJECTIVE :
Objective of the study is to determine the effectiveness of CISC in management of recurrent urethral strictures after visual internal urethrotomy.
METHODOLOGY :
This study performed in department of urology Saidu teaching hospital Swat from June 2016 to July 2019 on 215 patients who were diagnosed as having urethral stricture disease. Patients were counseled for CISC after removal of catheter 2 times a day for 8 weeks and at 8th week cystourethroscopy performed along with detail evaluation of symptoms of urethral stricture to know recurrence of stricture.
RESULTS:
81.39% patients have no urethral stricture on cystourethroscopy and symptomatic evaluation at 8th week post visual internal urethrotomy while 18.60% patients have recurrent urethral stricture . Length of urethral stricture is the most important prognostic factor, stricture of less than 1 cm has success rate of 62.39% while stricture of more than one cm length has success rate of 20% as shown in table IV.
CONCLUSION:
In this study it has been confirmed that CISC is safe ,cost effective procedure and most of the patients can do it in home with out any complications.
References
Steenkamp JW, De Kock ML. Epidemiology of urethral stricture at Tygerberg Hospital. South African Medical Journal. 1994;84(5):267-8.
Andrich DE, Mundy AR. Urethral strictures and their surgical treatment. BJU Int 2011:86;571.
Naude AM, Heyns CF. What is the place of internal urethrotomy in the treatment of urethral stricture disease? Nat Clin Pract Urol 2012;2:538-45.
Mohammad AS, Shahzad A, Mobasher AS, Nasir M, Role of clean intermittent self catheterization (CISC) in management of recurrent urethral strictures. 2010 Jan;23:1-7.
Greenwell TJ, Castle C, Andrich E, MacDonal JT, Nicol DL, Mundy AR. Repeat Urethrotomy and dilation for the treatment of urethral stricture are neither clinically effective nor cost-effective. J Urol 2014;172: 275-77.
Lauritzen M, Greis G, Sandberg A, Wedren H, Ojdeby G, Henningsohn L. Intermittent self-dilatation after internal urethrotomy for primary urethral strictures: a case-control study. Scand J Urol Nephrol 2009;43:220-5.
Khan S, Khan RA, Ullah A, 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. 2011 Apr-Jun;23(2):22-5.
Attwater HL. The history of urethral stricture. British Journal of Urology. 1943 Jun;15(2):39-51.
Lumen N, Hoebeke P, Willemsen P, De Troyer B, Pieters R, Oosterlinck W. Etiology of urethral stricture disease in the 21st century. The Journal of urology. 2009 Sep;182(3):983-7.
Levy A, Browne B, Fredrick A, Stensland K, Bennett J, Sullivan T, Rieger-Christ KM, Vanni AJ. Insights into the pathophysiology of urethral stricture disease due to lichen sclerosus: comparison of pathological markers in lichen sclerosus induced strictures vs nonlichen sclerosus induced strictures. The Journal of Urology. 2019 Jun;201(6):1158-63.
Fenton AS, Morey AF, Aviles R, Garcia CR. Anterior urethral strictures: etiology and characteristics. Urology. 2005 Jun 1;65(6):1055-8.
Fenton AS, Morey AF, Aviles R, Garcia CR. Anterior urethral strictures: etiology and characteristics. Urology. 2005 Jun 1;65(6):1055-8.
Rourke K, Hickle J. The clinical spectrum of the presenting signs and symptoms of anterior urethral stricture: detailed analysis of a single institutional cohort. Urology. 2012 May 1;79(5):1163-7.
Russell RH. The treatment of urethral stricture by excision. British Journal of Surgery. 1914;2(7):375-83.
Hillary CJ, Osman NI, Chapple CR. Current trends in urethral stricture management. Asian journal of Urology. 2014 Oct 1;1(1):46-54.
Kumar V, Dharwadkar S, Doshi C, Batta A. Role of intermittent self catheterization in prevention of recurrence of stricture urethra following visual internal urethrotomy: a prospective single centre study. International Surgery Journal. 2019 Mar 26;6(4):1093-6.
Greenwell TJ, Castle C, Nicol DL. Clean intermittent self-catheterization does not appear to be effective in the prevention of urethral stricture recurrence. Scandinavian journal of urology. 2016 Jan 2;50(1):71-3.
Ergün O, Güzel A, Armağan A, Koşar A, Ergün AG. 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. 2015 Jun;47(6):909-13.
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
Copyright (c) 2023 Naqib Ullah, Jamshid Nawaz, Muhammad Shoaib, Asif Khan, Nizam u din, Tauheed Fareed.