ABSTRACT
OBJECTIVE: Tamoxifen was not used earlier in clinical practice to decrease the urethral re-stricture rate after visual internal urethrotomy (VIU). In this study, we are the first to report the use of Tamoxifen as an adjuvant therapy to decrease the re-fibrosis and stricture recurrence post-VIU. PATIENTS AND METHODS: Between 2015 and 2017, 60 patients underwent VIU for post-traumatic bulbar urethral stricture ≤1 cm. They were randomly divided into 2 groups (30 patients each). The Tamoxifen group cases received Tamoxifen 10 mg twice daily for 6 months post-VIU. The control group did not receive any medications. All patients were evaluated using the IPSS score, uroflowmetry, and perineal ultrasonography preoperatively at 3 and 6 months. RESULTS: At presentation, there was no significant difference between patients of both groups in terms of IPSS score, Qmax, stricture width, and length. At 6 months follow-up, the mean IPSS score for the Tamoxifen group was 12.3 (8-19) in comparison with 20 (12-26) in the control group (p < 0.001). The Tamoxifen group had mean Qmax 11.1 mL/s (9-14), while those of the control group had mean Qmax 8.2 mL/s (6-10; p < 0.001). Using perineal ultrasound, only stricture width showed to be significantly smaller in the Tamoxifen group (p = 0.001). CONCLUSION: Tamoxifen seemed to be effective in reducing the recurrence of urethral stricture post-VIU. There was a significant improvement of the clinical outcome regarding Qmax and IPSS score after Tamoxifen adjuvant therapy.
Subject(s)
Tamoxifen/therapeutic use , Urethra/surgery , Urethral Stricture/drug therapy , Urethral Stricture/surgery , Urologic Surgical Procedures , Adolescent , Adult , Aged , Combined Modality Therapy , Female , Follow-Up Studies , Humans , Middle Aged , Perineum , Postoperative Period , Prospective Studies , Recurrence , Treatment Outcome , Young AdultABSTRACT
PIP: In the past, the Egyptian Information, Education and Communication Center (IEC) SIS/IEC Center has used research findings to develop messages on the health benefits of family planning to mothers and children, proper use of contraceptive methods, and the need for acquiring correct information. A recent analysis of the 1995 Egypt Demographic and Health Survey data on 9153 currently married women aged 15-49 aimed to generate preliminary audience segments and profiles of different groups of current users, never users, and discontinuers of family planning methods so the Center can develop messages on family planning and birth spacing. 47.1% of all women in the analysis currently used contraception. 19.8% had used contraception, but did not do so currently. 33.1% had never used contraception. The leading factors affecting contraceptive use were husband's approval, husband-wife communications, desire for more children, and religion. Based on what was learned from discontinuers, the Center made two general conclusions. It needs to design special messages targeting discontinuers or never users. These special messages need to concern the groups' knowledge about different family planning methods, side effects, birth spacing methods, and birth limiting methods. Husband involvement in family planning is essential. Thus, the Center needs to develop special messages geared to men. To do so, however, a cluster analysis for husbands would be helpful in message development.^ieng
