Direct Vision Internal Urethrotomy and Regular Clean Self Intermittent Catheterization for Short Bulbar Urethral Strictures: A Durable Solution

Abstract

Background: To evaluate durability of DVIU results and recurrence of stricture if the CSIC was done

regularly up to one year and weekly thereafter.

Methods: This retrospective study was conducted in the Department of Urology at tertiary care teaching

hospital of Avicenna medical college Lahore Pakistan. Files of all patients operated between January 2017

and July 2021 for single bulbar urethral strictures of less than 1-1.5cm size in length, iatrogenic, idiopathic,

traumatic or inflammatory origins were evaluated. Patient with multiple or complicated strictures of post

urethroplasty, post hypospadias repair, previous radiation or multiple DVIU were excluded from the study.

Data analysis of all patients who were on CSIC following direct vision internal urethrotomy were evaluated

at 3,6,12 and 24 months.

Results: Mean age of patients was 41.13 years with range between 26-74 years.Most Common cause of

urethral strictures were idiopathic 66(58.92%) followed by iatrogenic 27(24.11%) causes. After 24 months

of follow up 95 (84.82%) patients maintained urethral caliber up to 16 Fr. Failure or recurrence was found in

17 (15.18%) patients who required intervention.

Conclusion: Direct vision internal urethrotomy (DVIU) with regular clean intermittent self-catheterization

(CSIC)was found to have a good success rate in bulbourethral strictures up to 1cm in selected patients.