ABSTRACT
Background: Stricture urethra is a common surgical problem, especially in under developed countries
Objective: To determine the outcome of optical internal urethrotomy under local anesthesia in treatment of urethral stricture disease
Materials and methods: This descriptive study was conducted in department of Urology and Renal Transplantation, Quaid-e-Azam Medical College /Bahawal Victoria Hospital, Bahawalpur, from 1st July 2009 to 30th June 2012. Total number of 100 patients of age 16 to 75 years with diagnosis of stricture urethra of any etiology on Retrograde Urethrogram and MCUG 2cm in size or patients of stricture with neurogenic bladder, diabetes mellitis, congenital or malignant strictures were excluded from the study. Retrograde urethrogram and voiding cysto-urethrogram was done in every patient to assess stricture length and location. Then optical internal urethrotomy was performed under local anesthesia using 2% xylocain gel and 3mg inj. midazolam given intravenously for sedation. Patients were retained under observation in ward for 24 hours to assess complications like pain, bleeding and extravasation of urine. Follow up period was 6-12 months for these particular patients under study
Results: Majority of the patients [60%] were between 46 to 60 years of age. Iatrogenic injuries were the main cause [45%] followed by traumatic causes [40%]. The most common site was bulbous urethra in [59%] followed by membranous urethra [17%]. Post procedure morbidity comprised of irrigation fluid extravasations [3%], bleeding [6%] and urinary incontinence in [2%] patients. Recurrent strictures were noted in [15%] patients. In our study, initial success rate was [60%] and overall success rate was [83%]
Conclusion: Optical internal urethrotomy can safely be performed under local anesthesia as a day-care procedure and the procedure is well tolerated by the patient without any hospitalization and anesthesia risk