OUTCOME OF SINGLE OPTICAL INTERNAL URETHROTOMY IN NAÏVE URETHRA IN YOUNG POPULATION.

Objectives: To determine the outcome of Optical Urethrotomy for urethral stricture in young population.

Methodology: A total of 80 patients aged between 20 and 30 years presented and evaluated in urology outpatient clinic. Baseline uroflowmetery was performed in all patients, decrease flow rate (Qmax <15ml/second) were further evaluated with urethrogram. Patients with stricture length of <2cm were operated as day care surgery for the optical internal urethrotomy under spinal anesthesia. Catheter was kept for 3-5 days and patients were followed with uroflowmetery at 3 months’ interval for 12 months. Treatment failure was considered as low Qmax (<15ml/ second), requiring urethral dilatation or optical urethrotomy at any point of follow-up. Data was prospectively maintained in computerized performa. Statistical analysis was done on SPSS version 21.

Results: The mean age of our study population was 26.3+5.9 (median=24.5years). Out of 80 patients, 35 (43.7%) patients had unknown etiology, 18 (22.5%) patients had history of trauma, 16 (20%) patients had history of sexually transmitted infection and 11 (13.75%) patients had history of instrumentation. Pre-operatively, the mean Qmax was 8.4+2.1ml/second. Urethrogram findings showed stricture length of 1.3+0.5cm and bulbar urethra level was most commonly (n=61, 76.25%) affected. Stricture length on urethrogram was 1.3+0.5cm. Postoperatively, catheter was removed on 3.8+1day. Eighteen (22.5%) of patient presented with poor flow rate on 1^st follow-up, subsequently further 13 (16.25%), 7 (16.6%) and 5 (13.5%) patients presented with poor flow rate on 6^th, 9^th and 12^th month of follow-up respectively. Overall 25% patients required urethral dilatation and 28.7% patients required 2^nd Optical internal urethrotomy at the end of 12 months follow up. At the end of 12 months’ follow-up, 47.5% of patients presented with failure to single optical internal urethrotomy.   

Conclusion: Idiopathic etiology is common cause of urethral stricture in male ageing between 20 to 30 years. Approximately half of the patients needed urethral dilatation or repeat optical internal urethrotomy in first year of follow-up. Optical internal urethrotomy is feasible option in younger population with 43% success rate.

Key words: Urethral stricture, Optical Internal Urethrotomy.