FEATURES OF THE TREATMENT OF NON-CONTINUOUS URETHRAL STRICTURE USING MITOMYCIN C
DOI:
https://doi.org/10.11603/1811-2471.2023.v.i4.14313Keywords:
urethral stricture, mitomycin C, optical urethrotomy, IPSS scaleAbstract
SUMMARY. Restoration of normal urethral patency is one of the most difficult tasks in surgery for these conditions. Cytostatics are sometimes used to prevent the formation of strictures, in particular during iatrogenic interventions. Mitomycin C is used to treat or prevent the formation of scar changes in the postoperative period.
The aim – to find out the effectiveness of mitomycin C to prevent the formation of strictures during optical urethrotomy.
Material and Methods. 120 patients with urethral strictures and clinically pronounced urinary incontinence were examined and operated on. Patients were divided into 2 groups: control – optical urethrotomy was performed without the introduction of mitomycin C (n=45) and experimental – optical urethrotomy was performed with the introduction of mitomycin C (n=75). Optical urethrotomy was performed according to the standard technique using a urethrotome with a "cold" knife. Mitomycin C was used at a concentration of 0.2 mg/ml and injected into scar tissue.
Results. Strictures of iatrogenic genesis were most common and accounted for 55.0 %. In second place were post-traumatic strictures (24.2 %). Approximately the same number of patients had urethral stricture of inflammatory and idiopathic origin, respectively 10.0 and 10.8 %. The analysis of the localization of the stricture revealed that in 6.7 % of patients it is located in the navicular fossa, in 17.1 % – in the penile part of the urethra, in 55.8 % – in the bulbar part of the urethra, and in 20.4 % – in two or more damaged parts of the urethra. After optical urethrotomy, after 12 months of observation in the control group, 4 more patients showed signs of stricture recurrence. In the experimental group, no relapse was detected in any patient in relation to the previous control visit in 3 months.
Conclusion. Optical urethrotomy and optical urethrotomy with the introduction of mitomycin C are most effective for strictures up to 2 cm in length. For longer strictures, the use of mitomycin C is less effective.
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