Partially Obstructed Urethral Strictures Due to Balanitis Xerotica Obliterans Improved by the Use of Topical Tacrolimus: Experience at a Tertiary Care Centre.

IF 1 Q3 MEDICINE, GENERAL & INTERNAL
Cureus Pub Date : 2024-12-31 eCollection Date: 2024-12-01 DOI:10.7759/cureus.76678
Ahsan Ahmad, Md Zaid Imbisat, Qurana Khatoon
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Abstract

Introduction Balanitis xerotica obliterans (BXO) can cause phimosis, meatal stenosis, and urethral strictures. However, management of these conditions in BXO patients is difficult. Surgical interventions, with their own risks and complications, demonstrate higher rates of disease recurrence. Recently, topical applications of steroids and immunomodulators have been evaluated for their role in the management of urethral strictures associated with BXO. In this study, we evaluated the role of topical application of tacrolimus in urethral strictures associated with BXO. Materials and methods This was a prospective study on male patients having urethral strictures associated with BXO. Patients were thoroughly evaluated and advised topical application of 0.1% tacrolimus. They were then reevaluated at six weeks. If the effects of tacrolimus were found to be satisfactory, then patients were advised to continue this treatment for three months. After three months, the patients were again evaluated. At the time of each reevaluation, changes in uroflowmetry and International Prostate Symptom Score (IPSS) were noted. Results A total of 53 patients were included in this study. The mean values of pre- and post-tacrolimus maximum urinary flow rate on uroflowmetry(Qmax) were 12.00±1.43 m/s and 15.26±3.14 m/s, respectively (p<0.001). The mean values of pre- and post-tacrolimus IPSS scores were 18.55±2.28 and 13.04±4.72, respectively (p<0.001). Based on the results, the application of tacrolimus was found to be ineffective in those with strictures >2 cm in length. Of the 53 patients included in the study, 21 required surgical intervention, as their response to tacrolimus was unsatisfactory. Conclusion Topical application of tacrolimus is a safe and feasible treatment option for short-segment (≤2cm) urethral strictures associated with BXO.

局部使用他克莫司改善梗阻性闭塞性干性阴道炎所致部分梗阻尿道狭窄:三级保健中心的经验。
梗阻性干性Balanitis闭塞性干性Balanitis闭塞性干性Balanitis闭塞性干性Balanitis闭塞性干性Balanitis闭塞性干性Balanitis (BXO)可引起包茎、金属狭窄和尿道狭窄。然而,在BXO患者中管理这些情况是困难的。手术干预有其自身的风险和并发症,显示出更高的疾病复发率。最近,类固醇和免疫调节剂的局部应用已经评估了它们在治疗与BXO相关的尿道狭窄中的作用。在这项研究中,我们评估了局部应用他克莫司在尿道狭窄相关的BXO中的作用。材料与方法本研究为男性尿道狭窄伴BXO患者的前瞻性研究。对患者进行全面评估,并建议局部应用0.1%他克莫司。然后在六周后对他们进行重新评估。如果发现他克莫司的效果令人满意,那么建议患者继续这种治疗三个月。三个月后,再次对患者进行评估。在每次重新评估时,记录尿流法和国际前列腺症状评分(IPSS)的变化。结果本研究共纳入53例患者。他克莫司治疗前后最大尿流率Qmax平均值分别为12.00±1.43 m/s和15.26±3.14 m/s(长度为p2 cm)。在纳入研究的53例患者中,21例需要手术干预,因为他们对他克莫司的反应不令人满意。结论局部应用他克莫司治疗短段(≤2cm)尿道狭窄合并BXO是一种安全可行的治疗方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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