Management of urethral stricture in patients practising clean intermittent catheterization

Clean intermittent catheterization (CIC) is used commonly to treat patients with impaired bladder emptying. We treated 6 male patients who were experiencing difficulty with intermittent catheterization. Retrograde urethrography demonstrated stricture of the urethra in all of them and a false passage as well in one patient. Treatment consisted of urethral dilatation using filiform and followers in 4 patients and optical internal urethrotomy in the remaining 2 patients followed by urethral stenting using a 16 Fr. Teflon Foley catheter in all. The stenting Foley catheter was removed after 2 weeks. Subsequently 5 of the 6 patients had resumed CIC regimen to empty their urinary bladder. The sixth patient with a false passage could not perform CIC and suprapubic cystostomy was performed. During a follow-up of 6 of 18 months, none of these five patients developed recurrence of urethral stricture and all are practising CIC without any difficulty. Analysis of our data revealed that forceful manipulation during catheter insertion and significant urethral bleeding during catheterization are important contributory factors for the development of urethral stricture in patients practising CIC.