THE ROLE OF OPTICAL INTERNAL URETHROTOMY AT PRESENT SCENARIO
Journal Title: IJSR-International Journal Of Scientific Research - Year 2018, Vol 7, Issue 5
Abstract
BACKGROUND Urethral stricture Is a relatively common urological disorder which every urologist encounters in his regular urological practice. They pose a significant Problem from both clinical and economic point of view. The etiology of stricture urethra has changed over times. Trauma has taken Over Infection as the commonest cause. The trauma can be either External (Trauma) Or Internal ( Instrumentation ). Another Important Cause Is Balanitis Xerotica Obliterans also Known as Lichen Sclerosus. In a Small Group Of Patients, No Particular Cause Can Be Made Out And They are Grouped Under 'Idiopathic. 'The Management Of Stricture has also evolved over the times. Despite the availability of various options for the treatment of stricture urethra, Internal Urethrotomy has remained as a popular option among the urologists in view of its Simplicity, Safety and Shorter Learning Curve. Optical Internal Urethrotomy (Oiu) Is Best Suited For Single, Bulbar Strictures shorter than 2 Cm, with minimal spongiofibrosis and with no past Internal Urethrotomy. Optical Internal Urethrotomy (Oiu) may be contra-indicated In suspected Urethral Malignancy, Coagulation Disorders Or Active Infection. Optical Internal Urethrotomy (Oiu) is not Suited for Long Strictures (>2 Cm), Multiple Strictures, Previous Optical Internal Urethrotomy (Oiu), Strictures Other than bulbar . AIM OF THE STUDY — The impact of co morbid factor in the outcome of internal urethrotomy — Association of the site ,length of the stricture, with the outcome of internal urethrotomy. — The effect of Pharmacological adjuncts (mitomycin-c) to OIU. — Duration of catheterization after urethrotomy — Role of repeat urethrotomy METHODS This is a prospective observational and analytical study, conducted at the urology department, kilpauk medical college hospital and govt royapettah hospital chennai in the period between february 2016 to march 2017 . A total of 60 male patients, with an age ranged from 15 to 60 years presenting with anterior urethral stricture, were included in the study. RESULTS Most common etiological factor is secondary to iatrogenic .Most common site is bulbar urethra.Most common complication is recurrent stricture .Most common age group is 30 to 40 years of age and the most common presenting complaint is strain to void and thin stream of micturation .With OIU alone76.7 % of patients voiding well ,23.3% came with recurrent stricture . With OIU and mitomycin c 90 % of patients voiding well and the recurrence rate is about 10 % .Diabetes with uncontrolled blood sugar ,length and density of the stricture influencing significantly with results and recurrent stricture formation. CONCLUSION Optical internal urethrotomy is a safe,minimally invasive repeatable procedure for anterior urethral stricture with <1.5 cm with less spongiofibrosis. Mitomycin C significantly reduces the recurrence rate of urethral stricture following OIU,as seen in our study , it is Safe and easily available
Authors and Affiliations
Prof. Sivasankar Govindaraju, Dr. Jayaganesh Rajasekaran, Dr Arulkumar Ettappan
Keywords
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