Mostafa Diaaeldin, Higazy Ahmed, Raslan Mostafa L, Salim Mohamed S
Faculty of Medicine, Ain Shams University, Cairo, Egypt.
National Health Insurance Hospital, Cairo, Egypt.
Urologia. 2025 May;92(2):288-293. doi: 10.1177/03915603241283109. Epub 2024 Oct 10.
To assess the efficacy of Intralesional injection of mitomycin C (MMC) following visual internal urethrotomy (VIU) in the management of recurrent urethral stricture.
Fifty male patients diagnosed with recurrent single bulbar urethral stricture measuring less than 1.5 cm previously treated with VIU were randomly allocated into two equal groups, (Group A) planned for VIU only and (Group B) planned for VIU with intralesional MMC injection using Botox injection needle. All patients were objectively evaluated pre- and post-operatively at 3, 6, and 12 months using uroflowmetry, post-void residual urine volume, and retrograde urethrography.
Forty-five patients completed their follow-up in our study. Patients who underwent intralesional MMC injection showed significant improvement in uroflowmetry, post-voiding residual, and with a success rate (82.6% in Group B, compared to 50% in Group A with a highly statistically significant difference, -value: <0.001). VIU with MMC was the only factor associated with a marked decrease in stricture recurrence ( = 0.02) as shown in the Multivariate Cox regression analysis.
Intralesional injection of mitomycin C seems to be a safe and effective modality in reducing the recurrent stricture rate after VIU.
评估直视下尿道内切开术（VIU）后病灶内注射丝裂霉素C（MMC）治疗复发性尿道狭窄的疗效。
50例诊断为复发性单发球部尿道狭窄且狭窄长度小于1.5厘米、此前接受过VIU治疗的男性患者被随机分为两组，（A组）仅计划接受VIU治疗，（B组）计划接受使用肉毒杆菌毒素注射针进行病灶内MMC注射的VIU治疗。所有患者在术前以及术后3个月、6个月和12个月使用尿流率测定、排尿后残余尿量和逆行尿道造影进行客观评估。
45例患者完成了本研究的随访。接受病灶内MMC注射的患者在尿流率、排尿后残余尿量方面有显著改善，成功率（B组为82.6%，A组为50%，差异具有高度统计学意义，P值：<0.001）。如多变量Cox回归分析所示，VIU联合MMC是与狭窄复发显著降低相关的唯一因素（P = 0.02）。
病灶内注射丝裂霉素C似乎是一种安全有效的方法，可降低VIU后的狭窄复发率。
