Study the outcomes of intralesional injection of triamcinolone and mitomycin-C mixture versus triamcinolone alone injection following direct vision internal urethrotomy for treatment of anterior urethral stricture

Abstract

Purpose: To study the effect of dual agent (mixture of triamcinolone and mitomycin-C) after direct vision internal urethrotomy and compare the results with triamcinolone intralesional injection only.

Materials and methods: A total of 70 male patients with symptomatic anterior urethral stricture of size <2-2.5cm. Strictures >2.5 cm in size were excluded from the study. All Patients were randomized into two groups. In group A, dual agent (mixture of triamcinolone and mitomycin-C) is injected following DVIU. In group B, single agent (triamcinolone) is injected following DVIU. An indwelling 18 Fr Foley catheter of same make was left in place for 7-14 days. All patients were followed up for 6 weeks, 12 weeks and then every 3 monthly following trial of void (TOV) for 2 years.

Results: The overall recurrence rate group 1 was 42.85% (15 out of 35 patients) i.e. a success rate of 57.15% whereas recurrence rate group 2 was 20% (7 out of 35 patients) i.e. a success rate of 80%( p-value<0.05). Complication rates were comparable in both the groups (p-value >0.05).

Conclusion: In this study, we found mixture of triamcinolone and mitomycin-C is superior to triamcinolone alone in terms of recurrence rate and that the difference is significant (p- value<0.05). There are few studies using dual agents for paraurethral injection after DVIU.