The Role Clean Self Intermittent Catheterization Following Direct Vision Internal Urethrotomy in Reduction of Recurrence of Urethral Stricture

Abstract

Background : Urethral stricture is major health urological problem; urethral dilatation and internal optical urethrotomy were the only treatment. Clean Self catheterization follow direct visual internal urethrotomy has greatly decreased the recurrence of stricture. Objectives : To investigate the effect of clean self intermittent catheterization on recurrence rate following direct vision internal urethrotomy and to assess rate of complication of direct visual internal urethrotomy (DVIU) alone versus DVIU with self catheterization. Patients and Methods : This double blind case control study was conducted in Soba university hospital (SUH). A total of sixty two patients were selected randomly in to treatment group B (31 patients) and control group A (3I patients) all patients were treated with DVIU followed with indwelling catheter for three days. The treatment group B was taught to perform self clean intermittent catheterization by inserting size 16 Nelaton catheter daily for the first month then every other day for the next month and once weekly for the last third month. All patients were followed regularly at 3,6,12 months. Results : Twenty Four (77.41%) out of 31 patients in control group A developed urethral stricture recurrence while six (19.35%) patients in treatment group B had stricture recurrence (p lt;0.000). In control group A 14 patients (58.3%) out 24 had their recurrence in the first six months of follow-up while fife (83.3%) out of six in group B had their recurrence in the next six months of follow-up.In control group A four patients developed urinary tract infections all were positive for E.coli. In treatment group B urinary tract infections were found in three patients, culture was positive for E.coli in two patients and Klebsiella for the third one, and one patient developed epididymo-orchitis. Conclusion : Clean self intermittent catheterization is a simple, safe, cost effective and easy to perform procedure for prevention of urethral stricture with