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

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.

Mitomicina C colírio como tratamento para granuloma piogênico em cavidade anoftámica / Mitomicyn C eye drops as alternative treatment for pyogenic granuloma in anophthalmic socket

OBJETIVO: Avaliar a eficácia do uso tópico de colírio de mitomicina C 0,02 por cento (MMC 0,02 por cento) no tratamento de pacientes com granuloma piogênico em cavidade anoftálmica. MÉTODOS: Seis pacientes portadores de granuloma piogênico em cavidade anoftálmica foram submetidos ao tratamento com mitomicina C 0,02 por cento instilada quatro vezes ao dia durante ciclos quinzenais e intervalo de 15 dias entre os ciclos. Os pacientes foram acompanhados semanalmente. RESULTADOS: Foram acompanhados seis pacientes dos quais um apresentou resolução do granuloma piogênico ao final do primeiro ciclo de uso da MMC 0,02 por cento. Em dois pacientes a MMC 0,02 por cento foi eficaz na resolução da lesão após a segunda semana de tratamento (primeiro ciclo). Dois pacientes apresentaram resolução completa do granuloma piogênico na quinta semana de uso da MMC 0,02 por cento (início do segundo ciclo). Este fármaco foi ineficaz em apenas um paciente que persistiu com a lesão após dois ciclos de tratamento. Não foram observadas complicações decorrentes do uso de MMC 0,02 por cento em nenhum dos pacientes. CONCLUSÃO: A MMC 0,02 por cento tópica mostrou-se eficaz no tratamento de granuloma piogênico em cavidade anoftálmica, entretanto, diante de casuística pequena, torna-se necessário estudo mais amplo, comparando a eficácia da MMC 0,02 por cento com drogas já utilizadas no tratamento desta lesão, tais como os esteróides e antimetabólicos.

PURPOSE: To evaluate the efficacy of mitomycin C eye drops 0.02 percent concentration (0.02 percent MMC) in pyogenic granuloma in anophthalmic socket. METHODS: Six patients who presented pyogenic granuloma were treated with 0.02 percent MMC four times a day in fifteen-day cycles with intervals of fifteen days between each cycle. The patients were observed every week. RESULTS: Among the six studied patients, one presented a complete resolution of the pyogenic granuloma after a ten-day treatment with 0.02 percent MMC that is, before the end of the first cycle. In two patients, the treatment was successful after two weeks using 0.02 percent MMC (one complete cycle). In other two patients, the resolution of the lesion occurred after five weeks that is, at the beginning of the second cycle. 0.02 percent MMC was not successful in only one patient whose lesion persisted after two cycles of the treatment. None of the patients presented complications after the use of 0.02 percent MMC. CONCLUSION: The topical use of 0.02 percent MMC proved efficacy in the treatment of anophthalmic socket pyogenic granuloma. A small number of patients took part in this study, therefore another randomized and comparative research is necessary in order to compare the efficacy of 0.02 percent MMC with other drugs such as corticosteroids and antimetabolites.