Vol. 4, Issue 1, Part B (2020)

Materials and Methods: A total of 59 diagnosed short segment urethral stricture male patients who underwent for Visual Internal Urethrotomy from Jan 2018 to May 2019 were studied. The preoperative and postoperative AUA score, Uroflowmetry, Postvoidal residual urine were used to evaluate the effect of visual internal urethrotomy. Paired t test is used for statistical analysis of the result.

Result: The postoperative AUA score, uroflowmetry changes and postvoidal residual urine were improved significantly. There was significant change in the AUA score after VIU from 17.52 ± 11.53 preoperatively to 10.28 ± 05.25 and 09.88 ± 07.96 on postoperative 4^th and 12^th weeks (p<0.0001). There was significant change in the postvoidal residual urine from 149.75 ± 58.66 ml preoperatively to 35.56 ± 39.52 ml and 41.64 ± 80.05 ml postoperatively at 4^th and 12^th week respectively (p<0.0001). The mean stricture length of patients who underwent VIU was 1.74 ± 1.86 cm and the recurrence rate was 14.25% for length ≥ 2cm and 7.89% for length <2cm. Among the uroflowmetry parameters there was significant change in the maximum flow rate (Qm) from 10.20 ± 6.22 ml/s preoperatively to 22.93 ± 8.60 ml/s and 21.90 ± 10.63 ml/s postoperatively on 4^th and 12^th week respectively (p<0.0001). It was also found that the average flow rate in uroflowmetry had a significant change preoperatively from 4.36 ± 3.20 ml/s to 13.80 ± 6.04 ml/s and 13.17 ± 7.14 ml/s postoperatively on 4^th and 12^th weeks respectively (p<0.0001). The mean voided volume of patients who underwent for VIU found to have 236.42 ± 137.40 ml preoperatively, whereas at 4^th and 12^th postoperative weeks it was 415.12 ± 174.40 ml and 397.88 ± 216.01 ml respectively and the p value found to be <0.0001 which was significant. So it is evident that VIU have significant effect over voided volume. Patients with mild spongiofibrosis have got 100% success rate. Those patient who got severe spongiofibrosis have got a recurrence rate of 37.5% and moderate spongiofibrosis got a recurrence rate of 12%. Those patients who practiced clean intermittent self-catheterization after VIU had a good result (p = 0.0023) at the end of 12^th postoperative week. The success rate of VIU at the end of 12^th postoperative week found to be 89.83%.

Conclusion: Visual Internal Urethrotomy is a safe, minimally invasive, easy and time effective procedure for the treatment of short segment urethral strictures in male patients as a short term management. In short segment stricture urethra patients with mild spongiofibrosis, a single attempt of Visual Internal Urethrotomy can be considered as an initial procedure for short term management. Clean Intermittent Self Catheterization is to be advised to the patients for further effective outcome of urethrotomy.