THE ROLE OF OPTICAL INTERNAL URETHROTOMY AT PRESENT SCENARIO

Volume : VII, Issue : V, May - 2018

Prof. Sivasankar Govindaraju, Dr. Jayaganesh Rajasekaran, Dr Arulkumar Ettappan

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

spongiofiosis 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 feuary 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

spongiofiosis. Mitomycin C significantly reduces the recurrence rate of urethral stricture following OIU,as seen in our study , it is Safe and

easily available