International Journal of Medicine and Health Development (Jan 2024)

Direct visual internal urethrotomy in management of short segment urethral strictures in an African black population: Our preliminary experience

  • Okwudli C Amu,
  • Emmanuel A Affusim,
  • Solomon K Anyimba,
  • Chukwuka L Eneje,
  • Chukwunonso D Nwachukwu,
  • Chukwunonso A Iwenofu

DOI
https://doi.org/10.4103/ijmh.ijmh_5_24
Journal volume & issue
Vol. 29, no. 2
pp. 151 – 156

Abstract

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Background: Direct visual internal urethrotomy (DVIU), also known as optical urethrotomy, has become an established tool in the management of urethral strictures. Few prospective studies have reported experience with this endoscopic procedure in black Africans, who are generally believed to exhibit more fibrotic response in wound healing. Objectives: This study aims to determine the etiology, location, and length of strictures, as well as the complications of DVIU in a black African population. Materials and Methods: This hospital-based prospective study was conducted at 82 Division Military Hospital, Enugu, South-East Nigeria. Patients with single partial/incomplete short segment (<2 cm) urethral strictures confirmed on antegrade/retrograde urethrogram were included. The patients were monitored for post-operative complications. Results: Forty-eight patients completed the study. The mean age of patients was 65 years. Trauma was responsible for 17 (35.4%) of the strictures, followed by post-transurethral resection of prostate strictures 15 (31.3%). Most of the strictures were located in the bulbar area of the urethra 25 (52.1%). A total of 12 patients (25%) had membranous strictures. Complications observed after DVIU included primary hematuria requiring admission and irrigation in six patients (12.5%), urinary tract infection in six patients (12.5%), impotence in five patients (10.4%), penile bleeding requiring crepe bandage application in four patients (8.3%), secondary hemorrhage in one patient (2.1%), urinary retention after catheter removal in one patient (2.1%), and urinary incontinence in one patient (2.1%). Stricture recurrence occurred in 8 (16.7%) patients within 1 year of follow–up, while the majority of the patients 40 (83.3%) were stricture-free within the 1-year period. Conclusion: The outcomes of DVIU recorded in a Nigerian black population appear similar and comparable to other studies conducted elsewhere, both within and outside Africa.

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