EFFICACY OF OPTICAL INTERNAL URETHROTOMY WITH OR WITHOUT INTRALESIONAL MITOMYCIN C INJECTION IN RECURRENCE OF URETHRAL STRICTURE: A RANDOMIZED CONTROL TRIAL

Abstract

Background: Urethral stricture is a fibrotic narrowing of urethra that causes obstructive urinary symptoms and often recurs after treatment. Optical internal urethrotomy (OIU) is standard minimally invasive process, but recurrence remains a major issue. Mitomycin C, an antifibrotic agent, has been proposed as an assistant to reduce recurrence. Objective: To evaluate the efficacy of intralesional mitomycin C injection after OIU in reducing short -term urethra stricture recurrence. Methods: In this randomized controlled trial, 90 male patients aged 25–65 were diagnosed on the retrograde urethra with anterior urethra stricture. Patients were randomly allocated in two groups: Group A (OIU + intralesional mitomycin C, 0.1 mg in 2 mL distilled water) and Group B (OIU alone). All patients received postoperative antibiotic and a catheter for three days. Follow-up was followed in another three months, in which recurrence was defined by poor urinary stream or retention. The data was analyzed using Chi-Square and T-test, in which P <0.05 is considered important. Result: Baseline demographics were comparable. Mitomycin C group (6.7%) was quite low in three months compared to control (48.9%; p <0.001). Treatment efficacy, defined as the absence of recurrence, was higher in experimental group (88.9%) vs. control (53.3%; p <0.001). Diabetes mellitus and high blood pressure were associated with increased recurrence risk. Conclusion: After OIU Intralesional Mitomycin C significantly reduces short-term recurrence of the urethral stricture and is a safe, effective accessory therapy. Larger studies warrant with long-term follow-up