Shams-ul islam, Wajid Ali Baloch, Maisam Ali Shahid, Imran Ansari, Muhammad Haider.
Role of Mitomycin C in Anterior Urethral Stricture Recurrence after Internal Urethrotomy.
Pak J Med Health Sci Jan ;13(2):497-9.

Background: Urethral stricture, an ancient urologic disease, remains a common in men with high morbidity. IOU refers to procedure that opens the stricture by incising it transurethrally. The most common complication is recurrence. Mitomycin-C with its anti-fibroblast and anti-collagen properties has decreased the recurrence rate of trabeculectomy and myringotomy. Aim : To compare the efficacy of Mitomycin-C with internal urethrotomy versus internal urethrotomy alone in the prevention of stricture recurrence in anterior urethra. Study design : Randomized controlled trial . Setting and duration of study : Urology department of Jinnah teaching hospital, Lahore , 1.5 years Methodlogy : 80 men were included in the study after approval of study and informed consent from all patients. Patients were divided into A and B groups by lottery method : Group A underwent internal optical urethrotomy followed by sub-mucosal injection of 0.1mg mitomycin C in urethrotomy site (11 and 10 clock) and Group B patients were only treated with internal optical urethrotomy. A 16 Fr indwelling catheter was placed for 3 days in both groups. Patients were called after 3 months or earlier for follow up if patient becomes symptomatic and retrograde urethrogram was done. All the information was entered in a designed Performa . Results : In this study, out of 80 cases, patient’s age was 49.43 +/-8.10 years in Group-A and 48.98 +/-7.20 years in Group-B; mean length of stricture was 9.7 +/-0.26 cm in Group-A and 9.75 +/-0.29 cm in Group-B. Comparison of efficacy of Mitomycin-C with internal urethrotomy versus internal urethrotomy alone in the prevention of anterior urethral stricture recurrence shows that 24 (60%) in Group-A and 14( 35%) in Group-B had efficacy whereas 16 (40%) in Group-A and 26( 65%) did not show the efficacy (as per operational definition), P value 0.02. Conclusion : The efficacy of Mitomycin-C with IOU is significantly higher when compared with internal urethrotomy alone in the prevention of anterior urethral stricture recurrence rate .

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