Ergün Osman, Güzel Ahmet, Armağan Abdullah, Koşar Alim, Ergün Ayşe Gül
Department of Urology, KonyaTraining and Research Hospital, Konya, Turkey,
Int Urol Nephrol. 2015 Jun;47(6):909-13. doi: 10.1007/s11255-015-0990-4. Epub 2015 Apr 26.
Our aim was to evaluate clean intermittent catheterization (CIC) results in combination with triamcinolone ointment and contractubex ointment for lubrication of the catheter after optical internal urethrotomy (OIU).
Ninety patients who underwent OIU were randomized into three groups. Two weeks after operation, patients were treated with CIC (group A), triamcinolone ointment CIC (group B), and contractubex ointment CIC (group C). Follow-up continued for 24 months after the OIU. Postoperative results were compared between the three groups.
There were no significant differences in the baseline characteristics of the patients or the etiology of the urethral stricture between the three groups. The mean preoperative Q max was 4.31 ml/s. The average score of preoperative international prostate symptom score (IPSS) was 23.1 points. In both groups, after treatment, significant improvements in Q max and IPSS were noted at all follow-up period (p < 0.05). But for Q max and IPSS, there were not any significant differences between groups at all follow-up period (p > 0.05). Overall recurrence rate was 28.9 % (26 out of 90 patients) at the end of the study. Recurrence rates were, however, not found to be statistically significant between these three groups (p > 0.05).
Our results indicate that the urethral dilation protocol with CIC after first OIU is a safe, simple, well-tolerated, office-based procedure. Triamcinolone or contractubex ointments of the CIC do not provide an additional benefit. Currently, urethral dilation with CIC after first OIU seems to be the only proven procedure that decreased the recurrence rate.
我们的目的是评估在光学尿道内切开术(OIU)后,清洁间歇性导尿(CIC)联合曲安奈德软膏和康瑞保软膏用于导尿管润滑的效果。
90例行OIU的患者被随机分为三组。术后两周,患者分别接受CIC治疗(A组)、曲安奈德软膏CIC治疗(B组)和康瑞保软膏CIC治疗(C组)。OIU后随访持续24个月。比较三组的术后结果。
三组患者的基线特征或尿道狭窄病因无显著差异。术前平均最大尿流率(Q max)为4.31 ml/s。术前国际前列腺症状评分(IPSS)平均得分为23.1分。两组在治疗后,所有随访期的Q max和IPSS均有显著改善(p < 0.05)。但对于Q max和IPSS,各随访期组间均无显著差异(p > 0.05)。研究结束时总体复发率为28.9%(90例患者中有26例)。然而,这三组之间的复发率无统计学差异(p > 0.05)。
我们的结果表明,首次OIU后采用CIC的尿道扩张方案是一种安全、简单、耐受性良好的门诊手术。CIC联合曲安奈德或康瑞保软膏并无额外益处。目前,首次OIU后采用CIC进行尿道扩张似乎是唯一经证实可降低复发率的方法。