Holmium Laser Uretherotomy in Combination With Intralesional Steroids in Bulbar Uretheral Stricture

Ain Shams University124 enrolled

Overview

the purpose is to evaluate the outcome of visual internal uretherotomy with Holmium laser along with intralesional steroid injection.

In this study, the investigator evaluates the efficacy of Holmium laser in combination with intra lesional steroid injection in the treatment of bulbar urethral strictures

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

DOUBLE

Enrollment

124

Conditions

Urethral Stricture

Interventions

Laser uretherotomyPROCEDURE

Holmium YAG Laser with pulse energy from 1-2 Joule, frequency from 10-15 Hertz and total power from 3.0 to 30.0 Watt were set up, respectively, based on the extent of the lesions. Scar tissue was incised at the position of 12-o'clock under the guidance of guidewire or ureteric catheter till fresh mucosa appeared.

Laser uretherotomy with triamcinolonePROCEDURE

After laser urethrotomy, 80 mg of triamcinolone (diluted with normal saline to 10 ml) will be injected by using an injection needle (5 F size and 23 G needle size) at 10 sites, 1 ml each, along the site of urethrotomy and circumferentially.

Eligibility

Sex: MALEMin age: 26 YearsMax age: 69 Years

Medical Language ↔ Plain English

Inclusion Criteria: 1. Presence of obstructive symptoms, 2. Short segment strictures (stricture length \<2 cm) as evident on radiological studies, i.e. retrograde urethrography and micturating cystourethrography. 3. Peak flow rate on uroflowmetry less than 15 ml/s Exclusion Criteria: 1. Complete obliteration of lumen of urethra on urethroscopy, 2. Balanitis Xerotica Obliterans, 3. Age less than 18 years, 4. Multiple strictures, 5. Active urinary tract infection, 6. Recurrent Strictures. 7. Prior internal uretherotomy 8. Prior urethroplasty 9. Pan-anterior urethral strictures 10. Posterior stenosis 11. Those who lost to follow up

Locations (1)

Ain Shams university

Cairo, Egypt

Outcomes

Primary Outcomes

the maximum flow rate (Qmax) is >15 ml/s at 3 and 6 months after procedure

The procedure will be accepted as successful when the maximum flow rate (Qmax) is \>15 ml/s.

Time frame: 3 and 6 months

Data from ClinicalTrials.gov

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