Role of Steroids in Reducing Recurrence of Urethral Stricture after Direct Vision Internal Urethrotomy

Abstract

Background: Recurrence of urethral strictures is the most frequent and bothersome complication, with majority of stricturesrecurring after optical internal urethrotomy. The objective of this study was to establish the role of oral steroid therapy after direct vision internal urethrotomy (DVIU) in minimizing recurrence of urethral stricture. Methodology: It was a randomized controlled trial carried out at Armed Forces Institute of Urology, Rawalpindi from January 2018 to March 2021. A total of 180 male patients with urethral stricture of ≤2 cm were included. Patients with traumatic stricture, post-anastomotic urethroplasty strictures, neurogenic bladder and history of steroid intake were excluded. Patients were randomly categorized into two groups i.e. Group A patients were given oral prednisolone (6 mg tablet twice daily for 4 weeks) while group B was control group. Patients were followed up to 12 months for recurrence of stricture. Results: The mean age of patients in group A was 44.38 ± 8.03 years while in group B was 46.64 ± 6.66 years. The mean length of stricture in group A was 0.93 ± 0.26 cm and in group B was 0.95 ± 0.27 cm. Recurrence of stricture was seen in 18 (20.0%) patients in group A (oral steroids group) and 42 (46.67%) patients in group B (no oral steroids) with p-value of 0.0001. Conclusion: Oral prednisolone therapy after internal urethrotomy waseffective in decreasing the rate of recurrence of urethral stricture. Keywords: Oral, Recurrence, Steroid, Urethral Stricture.