Ali Liaqat, Shahzad Muhammad, Orakzai Nasir, Khan Ihsanullah, Ahmad Mubashira
Department of Urology, Institute of Kidney Diseases Hayatabad Medical Complex, Peshawar, Pakistan.
Department of Surgery, Khyber Teaching Hospital, Peshawar, Pakistan.
Korean J Urol. 2015 Sep;56(9):650-5. doi: 10.4111/kju.2015.56.9.650. Epub 2015 Sep 2.
To determine the efficacy of mitomycin C in reducing the recurrence of anterior urethral stricture after internal optical urethrotomy (IOU).
This was a randomized controlled trial conducted in the Department of Urology at the Institute of Kidney Diseases Peshawar from March 2011 to December 2013. A total of 151 patients who completed the study were divided into two groups by the lottery method. Group A (cases) comprised 78 patients in whom mitomycin C 0.1% was injected submucosally in the stricture after conventional IOU. Group B (controls) comprised 73 patients in whom IOU only was performed. Self-clean intermittent catheterization was not offered in either group. All patients were regularly followed up for 18 months. Recurrence was diagnosed by use of retrograde urethrogram in all patients and flexible urethroscopy in selected cases. Data were collected on a structured pro forma sheet and were analyzed by SPSS.
The mean age of the patients in group A was 37.31±10.1 years and that in group B was 40.1±11.4 years. Recurrence of urethral stricture was recorded in 11 patients (14.1%) in group A and in 27 patients (36.9%) in group B (p=0.002). The mitomycin group also showed a delay in recurrence compared with the control group (p=0.002).
Recurrence of urethral stricture is high after optical urethrotomy. Mitomycin C was found to be highly effective in preventing the recurrence of urethral stricture after IOU.
确定丝裂霉素C在降低内镜下尿道内切开术（IOU）后前尿道狭窄复发率方面的疗效。
这是一项于2011年3月至2013年12月在白沙瓦肾病研究所泌尿外科进行的随机对照试验。采用抽签法将总共151例完成研究的患者分为两组。A组（病例组）78例患者，在常规IOU后于狭窄处黏膜下注射0.1%丝裂霉素C。B组（对照组）73例患者，仅接受IOU。两组均未提供自行清洁间歇性导尿。所有患者均定期随访18个月。所有患者均通过逆行尿道造影诊断复发情况，部分病例通过软性尿道镜检查诊断。数据收集于结构化表格，并采用SPSS进行分析。
A组患者的平均年龄为37.31±10.1岁，B组为40.1±11.4岁。A组有11例患者（14.1%）出现尿道狭窄复发，B组有27例患者（36.9%）出现复发（p = 0.002）。与对照组相比，丝裂霉素组的复发时间也有所延迟（p = 0.002）。
内镜下尿道内切开术后尿道狭窄复发率较高。发现丝裂霉素C在预防IOU后尿道狭窄复发方面非常有效。
