Gupta Sandeep, Roy Sayak, Pal Dilip Kumar
Institute of Post Graduate Medical Education and Research, Kolkata, India.
Turk J Urol. 2018 Jan;44(1):42-44. doi: 10.5152/tud.2017.66564. Epub 2017 Dec 19.
Optical internal urethrotomy is a feasible modality of treatment for short segment bulbar urethral strictures. Recurrence is an important problem after urethrotomy. This study aimed at evaluating the efficacy of oral steroid (deflazocort) in reducing the recurrence of strictures after urethrotomy. Up to date, no study has evaluated the role of oral steroids after urethrotomy.
In this case-control study, patients undergoing urethrotomy (bulbar urethral strictures <2 cm) were divided into two groups according to patients receiving (Group 1) or not receiving (Group 2) oral steroid (deflazocort 6 mg tablets) after operation. Both groups were controlled at 1, 3 and 6 months after catheter removal (usually 5-6 days after operation) with uroflowmetry, and the flow rates were statistically compared. Deflazocort was given after catheter removal, at first 6 mg twice daily for two weeks, then 6 mg once daily for another two weeks (self-obturation was not performed).
A total of 72 patients were selected for the study as per inclusion criteria. They were divided into 2 groups as those receiving (Group 1: deflazocort group; n=36) or not receiving (Group 2; n=36) deflazocort. Median postoperative maximum flow rates in the deflazocort group were 26.2, 22.3 and 18.2 mL/sec, and in the control group was 24.4, 17.1 and 13.7 mL/sec at postoperative 1., 3. and 6. months, respectively. Lesser patients in the deflazocort group had recurrence. The difference was statistically significant only at postoperative 3 (p value=0.03), and 6. months (p value=0.02) (p value=0.15).
Oral steroids can be used after internal urethrotomy to reduce the recurrence of urethral strictures.
光学尿道内切开术是治疗短段球部尿道狭窄的一种可行方法。尿道切开术后复发是一个重要问题。本研究旨在评估口服类固醇（地夫可特）在降低尿道切开术后狭窄复发率方面的疗效。迄今为止，尚无研究评估尿道切开术后口服类固醇的作用。
在本病例对照研究中，接受尿道切开术（球部尿道狭窄<2 cm）的患者根据术后是否接受口服类固醇（地夫可特6毫克片剂）分为两组（第1组）或不接受（第2组）。两组在拔除导尿管后1、3和6个月（通常在术后5 - 6天）进行尿流率测定，并对流速进行统计学比较。地夫可特在拔除导尿管后给予，最初每日两次，每次6毫克，共两周，然后每日一次，每次6毫克，再持续两周（未进行自我闭塞）。
根据纳入标准，共72例患者入选本研究。他们被分为两组，一组接受地夫可特（第1组：地夫可特组；n = 36），另一组不接受（第2组；n = 36）。地夫可特组术后1、3和6个月的术后最大流速中位数分别为26.2、22.3和18.2毫升/秒，对照组分别为24.4、17.1和13.7毫升/秒。地夫可特组复发患者较少。差异仅在术后3个月（p值 = 0.03）和6个月（p值 = 0.02）有统计学意义（p值 = 0.15）。
尿道内切开术后可使用口服类固醇以降低尿道狭窄的复发率。
