DVIUDirect Vision Internal Urethrotomy
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In our present study, most of the recurrent strictures (60%) are managed by DVIU and no patient required CIC after DVIU.
2006 [86] 0% Present study 0% Table 5: Management of restricture Restricture managed study By DVIU McAninch JW et al.1997 [84] 88% Netto et al.
During the period of 1983-93, a total of 151 (9.4%) stricture urethra patients were admitted; 96 (63.5%) were treated by intermittent dilatation, 25 (16.5%) with DVIU, 11 (7.2%) patients with
Although the majority of the patients (n=247; 36.2%) were treated by DVIU and (n=210; 30.7%) intermittent dilatation, but there was overall rise in urethral reconstructive surgery like EPA was done in 151 (22.1%) cases and BMG urethroplasty in anterior urethral stricture repair in 9 (1.3%) cases.
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.
Several adjuvant therapies, including brachytherapy, injection of captopril, steroids and mitomycin C have been proposed to minimize the recurrence rate of urethral strictures after Direct visual Internal urethrotomy (DVIU) (3,4,5) Mitomycin C is an alkylating antineoplastic antibiotic derived from Streptomyces Caespitosus.
In this comparative study, we investigated the results of urethral sub mucosal injection of mitomycin C (0.1mg) at the urethrotomy site, on the recurrence rate of the stricture following direct visual internal urethrotomy (DVIU).
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.
The one that is most appealing to urologists and patients is DVIU, as it is a minimally invasive, outpatient, endoscopic procedure.
DVIU as a surgical treatment for urethral stricture was popularized after the initial report of Sachse in 1974.
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.
Virtually all patients (84%) had undergone prior dilation or DVIU. In total, 148 patients (25%) had a Charlson comorbidity score of 1 or more and 117 (19%) patients were current smokers as defined by smoking within 1 month of surgery (data available for 558 out of 604 patients).[sup.10]