Intermittent self-dilatation after internal urethrotomy for primary urethral strictures: a case-control study

Area of Science:

• Urology
• Surgical Innovation
• Patient Self-Management

Background:

• Urethral strictures are a common urological condition requiring effective treatment.
• Internal urethrotomy is a primary surgical intervention, but recurrence rates can be high.
• Postoperative management strategies are crucial for improving long-term outcomes.

Purpose of the Study:

• To evaluate the impact of intermittent self-dilatation (ISD) on the natural progression of urethral strictures.
• To assess whether ISD influences the recurrence rate following internal urethrotomy.
• To determine if ISD affects the time to recurrence after initial surgical treatment.

Main Methods:

• Retrospective case-control analysis of 217 male patients undergoing first-time internal urethrotomy for urethral strictures (1998-2000).
• Comparison between patients treated with internal urethrotomy alone (162) and those with additional postoperative ISD (55).
• Data collected included stricture characteristics, treatment details, and follow-up for 3-6 years.

Main Results:

• The median time to recurrence was significantly longer in the ISD group (732 days) versus the non-ISD group (167 days) (p<0.0001).
• Recurrence frequency was 9% in the ISD group compared to 31% in the non-ISD group (p=0.0007).
• Traumatic etiology and absence of a postoperative catheter were associated with higher recurrence risk.

Conclusions:

• Postoperative intermittent self-dilatation (ISD) is a valuable adjunct to internal urethrotomy for urethral strictures.
• ISD demonstrably reduces the rate of stricture recurrence.
• ISD significantly delays the time until surgical reoperation is required.