DVIUDirect Vision Internal Urethrotomy
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2006 [86] 0% Present study 0% Table 5: Management of restricture Restricture managed study By DVIU McAninch JW et al.
After suprapubic cystostomy, antigrade and retrograde urethrogram is done under local or general anaesthesia which is also accompanied by rigid or flexible urethro cystoscopy from above and below to see the site, length of stricture and associated abnormalities of bladder, but many cases in this series were referred from all over the country with previous history of railroad catheterisation, DVIU, dilatation and failed urethroplasty.
The search for better treatment continued and if we see the management trends in the 2nd decade (1983-1993), there was a trend towards DVIU and at the same time there was the beginning of EPA urethroplasty.
During this period, DVIU was the commonest operation done for stricture urethra and also 151 patients underwent EPA urethroplasty, and also BMG was introduced during this period which replaced the option of perineal urethrostomy for anterior urethral stricture.
DVIU again was the commonest operation done in 356 patients during this period; 11 out of these DVIU patients were done by antegrade and retrograde route for pelvic fracture urethral distraction defects, but, unfortunately, all of these had recurrence of stricture and were subjected to urethroplasty.
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%.
Mazdak and colleagues from Isfahan, Iran where mytomycin C was injected submucosally after DVIU and recurrence rate compared.
In our study as shown in table 1 and 2, DVIU group had 22 patients with mean age of 30.
CONCLUSION: Submucosal injection of Mitomycin C after DVIU is effective in reducing the rate of early recurrence in our short term follow up study.
Albers et al reported that urethral catheterization left for [less than or equal to] 3 days following DVIU is associated with lower recurrence rate compared with longer duration (34% vs.
As the outcome criteria is not standardized following DVIU, we followed our patients with uroflowmetry (Qmax ml/s).
The theory behind CIC following DVIU is that the process of self-catheterizsation prevents the scar from contracting while it matures.