Department of Urology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
J Endourol. 2012 Aug;26(8):1049-52. doi: 10.1089/end.2011.0583.
Optical internal urethrotomy is the most commonly performed procedure for the management of anterior urethral stricture. This study was performed to compare the safety and efficacy of spongiosum block along with intraurethral lignocaine with intraurethral lignocaine alone for optical internal urethrotomy.
Fifty patients with anterior urethral stricture were prospectively randomized to undergo optical internal urethrotomy under spongiosum block along with intraurethral lignocaine (group 1=25 patients) and intraurethral lignocaine only (group 2=25 patients). The procedure-related pain was noted using the visual analogue scale. Postprocedure evaluation was performed by uroflowmetry and urethral calibration. Retrograde urethrography and micturating cystourethrography were performed as needed.
Optical internal urethrotomy was successfully completed in all patients. The mean visual analogue score for pain in group 1 (1.5 ± 1.4) was significantly lower than the score in group 2 (2.7 ± 1.8) (P=0.006). At 6 months follow-up, recurrent strictures developed in three patients in group 1 and five patients in group 2.
Spongiosum block with intraurethral lignocaine has a better anesthetic effect than intraurethral lignocaine alone for performing optical internal urethrotomy. Spongiosum block with intraurethral lignocaine is a viable alternative for regional and general anesthesia in the management of anterior urethral stricture with optical internal urethrotomy.
尿道内切开术是治疗前尿道狭窄最常用的方法。本研究旨在比较海绵体阻滞联合尿道内利多卡因与单纯尿道内利多卡因用于尿道内切开术的安全性和疗效。
50 例前尿道狭窄患者前瞻性随机分为海绵体阻滞联合尿道内利多卡因（组 1=25 例）和单纯尿道内利多卡因（组 2=25 例）行尿道内切开术。采用视觉模拟评分法记录手术相关疼痛。术后通过尿流率和尿道测压评估。必要时行逆行尿道造影和排尿性膀胱尿道造影。
所有患者均成功完成尿道内切开术。组 1 的平均视觉模拟评分（1.5±1.4）明显低于组 2（2.7±1.8）（P=0.006）。6 个月随访时，组 1 中有 3 例患者和组 2 中有 5 例患者出现复发性狭窄。
与单纯尿道内利多卡因相比，尿道内利多卡因联合海绵体阻滞用于尿道内切开术具有更好的麻醉效果。在尿道内切开术治疗前尿道狭窄时，尿道内利多卡因联合海绵体阻滞是区域麻醉和全身麻醉的可行替代方法。
