A Prospective, Comparative Study on the Effect of Mitomycin C on Anterior Urethral Stricture Recurrence After Internal Urethrotomy

Abstract

Direct visual internal urethrotomy (DVIU) is the most commonly performed procedure for bulbar urethral stricture disease of length 10mm or less. DVIU alone, classically, has a poor long-term success rate. The objective of this prospective study conducted at VIMS Bellary from Sep 2012 to Aug 2013 is to compare the effect of submucosal injection of mitomycin-C after DVIU on recurrence rate of bulbar urethral stricture with DVIU alone. MATERIALS AND METHODS: Forty five male patients with bulbar urethral strictures of 10mm or less were included in the study with every alternate patient undergoing DVIU was injected urethral submucosal Mitomycin-C(0.1mg) at the urethrotomy site. Mitomycin C injected in 23 patients. Mean stricture length, as measured by retrograde urethrography (RUG) was 0.75 cm. Mean preoperative uroflow was 10.5ml/sec. The patients were re-evaluated after 6 months and 1 year by uroflow, USG abdomen and RGU, and the stricture recurrence rate was compared between the two groups. RESULTS: Analysis of the results revealed a stricture recurrence rate of 47% in the DVIU only group while the recurrence rate in the Mitomycin C group was only 13%. This difference was statistically significant. The mean uroflow of the recurrences in the Mitomycin C group was 13 ml/sec,and DVIU group 11.75 ml/sec. CONCLUSIONS: Submucosal injection of Mitomycin C after DVIU is effective in reducing the rate of early recurrence in our short term follow up study.However further studies are required to know the long term results. In our study aetiology of stricture has no relation to the recurrence rate after DVIU.