Jhanwar Ankur, Sokhal Ashok Kumar, Singh Kawaljit, Sankhwar Satyanarayan, Saini Durgesh Kumar
Department of Urology, King George's Medical University, Lucknow, Uttar Pradesh, India.
Urol Ann. 2018 Oct-Dec;10(4):395-399. doi: 10.4103/UA.UA_34_17.
Clean intermittent catheterization (CIC) after direct vision internal urethrotomy (DVIU).
The aim is to assess the quality of life (QOL) in patients with urethral strictures on CIC following DVIU.
Prospective study.
This prospective study was conducted between August 2013 and July 2015 in the Department of Urology at KGMU, Lucknow. We included patients above the age of 18 years with stricture urethra, who were on CIC following direct visual internal urethrotomy. Patients below the age of 18 years, noncompliance, concomitant neurogenic voiding dysfunction, multiple strictures, pan anterior strictures, and posterior stenosis were excluded from the study. A 16 French Foley catheter was used for CIC following DVIU. Patients were evaluated at follow-up visit at 3, 6, and 12 months. At each follow-up visits, patients were assessed using CIC-QOL questionnaire, maximum urine flow rate and complications related to CIC if any.
Unpaired -test was used to compare continuous data, and Fisher's exact test was used to analyze categorical data.
Among total 144 male patients evaluated, we included 97 patients, who underwent DVIU. Mean age of the study population was 37.7 ± 14.03 years. Most urethral strictures were idiopathic (64.02%) followed by postinflammatory (24.25%). A significant number of patients reported difficulty in performing CIC, which hampered daily activities. No major procedure related complications were reported. Patients who were compliant to CIC reported no stricture recurrence till 6 months follow-up.
CIC following DVIU remains a reasonable adjunctive option. All the parameters of CIC-QOL questionnaire had improved on continuing CIC. Young men on CIC had greater impairment of QOL when compared to aged patients.
直视下尿道内切开术后清洁间歇性导尿(CIC)。
评估直视下尿道内切开术后接受CIC的尿道狭窄患者的生活质量(QOL)。
前瞻性研究。
这项前瞻性研究于2013年8月至2015年7月在勒克瑙KGMU泌尿外科进行。我们纳入了年龄在18岁以上、患有尿道狭窄且在直视下尿道内切开术后接受CIC的患者。年龄在18岁以下、不依从、伴有神经源性排尿功能障碍、多处狭窄、全前尿道狭窄和后尿道狭窄的患者被排除在研究之外。直视下尿道内切开术后使用16F Foley导尿管进行CIC。在3个月、6个月和12个月的随访时对患者进行评估。每次随访时,使用CIC-QOL问卷对患者进行评估,测量最大尿流率,并评估与CIC相关的并发症(如有)。
采用非配对t检验比较连续数据,采用Fisher精确检验分析分类数据。
在总共评估的144例男性患者中,我们纳入了97例接受直视下尿道内切开术的患者。研究人群的平均年龄为37.7±14.03岁。大多数尿道狭窄为特发性(64.02%),其次是炎症后狭窄(24.25%)。相当数量的患者报告在进行CIC时存在困难,这妨碍了日常活动。未报告与主要手术相关的并发症。依从CIC的患者在6个月随访时未报告狭窄复发。
直视下尿道内切开术后CIC仍然是一种合理的辅助选择。持续进行CIC后,CIC-QOL问卷的所有参数均有所改善。与老年患者相比,接受CIC的年轻男性生活质量受损更严重。