Korean J Urol.  2015 Sep;56(9):650-655. 10.4111/kju.2015.56.9.650.

Efficacy of mitomycin C in reducing recurrence of anterior urethral stricture after internal optical urethrotomy

Affiliations
  • 1Department of Urology, Institute of Kidney Diseases Hayatabad Medical Complex, Peshawar, Pakistan. liaqat_99@yahoo.com
  • 2Department of Surgery, Khyber Teaching Hospital, Peshawar, Pakistan.

Abstract

PURPOSE
To determine the efficacy of mitomycin C in reducing the recurrence of anterior urethral stricture after internal optical urethrotomy (IOU).
MATERIALS AND METHODS
This was a randomized controlled trial conducted in the Department of Urology at the Institute of Kidney Diseases Peshawar from March 2011 to December 2013. A total of 151 patients who completed the study were divided into two groups by the lottery method. Group A (cases) comprised 78 patients in whom mitomycin C 0.1% was injected submucosally in the stricture after conventional IOU. Group B (controls) comprised 73 patients in whom IOU only was performed. Self-clean intermittent catheterization was not offered in either group. All patients were regularly followed up for 18 months. Recurrence was diagnosed by use of retrograde urethrogram in all patients and flexible urethroscopy in selected cases. Data were collected on a structured pro forma sheet and were analyzed by SPSS.
RESULTS
The mean age of the patients in group A was 37.31+/-10.1 years and that in group B was 40.1+/-11.4 years. Recurrence of urethral stricture was recorded in 11 patients (14.1%) in group A and in 27 patients (36.9%) in group B (p=0.002). The mitomycin group also showed a delay in recurrence compared with the control group (p=0.002).
CONCLUSIONS
Recurrence of urethral stricture is high after optical urethrotomy. Mitomycin C was found to be highly effective in preventing the recurrence of urethral stricture after IOU.

Keyword

Surgery; Urethral diseases; Urethral stricture; Urinary bladder neck obstruction

MeSH Terms

Adult
Follow-Up Studies
Humans
Injections, Intralesional
Male
Middle Aged
Mitomycin/*administration & dosage
Nucleic Acid Synthesis Inhibitors/*administration & dosage
Recurrence
Time Factors
Urethral Stricture/*prevention & control/radiography/surgery
Urodynamics
Urologic Surgical Procedures/methods
Mitomycin
Nucleic Acid Synthesis Inhibitors

Figure

  • Fig. 1 Bar graph showing different etiological factors in urethral stricture. Pearson chi-square=0.164.

  • Fig. 2 Bar graph showing site of urethral stricture.


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