Background: To evaluate durability of DVIU results and recurrence of stricture if the CSIC was done regularly up to one year and weekly thereafter. Methods: This retrospective study was conducted in the Department of Urology at tertiary care teaching hospital of Avicenna medical college Lahore Pakistan. Files of all patients operated between January 2017 and July 2021 for single bulbar urethral strictures of less than 1-1.5cm size in length, iatrogenic, idiopathic, traumatic or inflammatory origins were evaluated. Patient with multiple or complicated strictures of post urethroplasty, post hypospadias repair, previous radiation or multiple DVIU were excluded from the study. Data analysis of all patients who were on CSIC following direct vision internal urethrotomy were evaluated at 3,6,12 and 24 months. Results: Mean age of patients was 41.13 years with range between 26-74 years.Most Common cause of urethral strictures were idiopathic 66(58.92%) followed by iatrogenic 27(24.11%) causes. After 24 months of follow up 95 (84.82%) patients maintained urethral caliber up to 16 Fr. Failure or recurrence was found in 17 (15.18%) patients who required intervention. Conclusion: Direct vision internal urethrotomy (DVIU) with regular clean intermittent self-catheterization (CSIC)was found to have a good success rate in bulbourethral strictures up to 1cm in selected patients.

Background: Lower ureteric calculi can be treated by different modalities. There are many minimally invasive interventional (e.g.,ESWL, ureterorenoscopy, the holmium: YAG laser and basket devices) as well as expectant (watchful waiting) treatments are in practice for the management of distal ureteric calculi. selected method depend on the type of equipment available, location, type and size of stone, needs of the patient and skills of the surgeon. Most of the work on the potency of tamsulosin in lower ureteric calculi expulsion has been done in the developed countries. Methods: Our randomized controlled trial in Avicenna Hospital Lahore included 100 patients over 18 years of age with stone Size ≤8mm in distal one third of ureter. Patients were randomly assigned into two groups (A & B). Group A Patients were given Capsule Tamsulosin 0.4 mg, once daily up to four weeks while group B patients were given placebo, one Capsule daily up to four weeks. The final result was the expulsion rate. Informed consent was obtained from all the patients. Stone Expulsion time, analgesia requirement, need for hospitalization and drug adverse effects were secondary endpoints. Results: A total of 49 patients in group A and 48 patients in group B came for follow up, therefore 97 out of 100 patients were evaluated. Mean age of the patients was 36.34 years (range 18–57 years). Mean stone size was 5.78 mm (range 4–8 mm) in largest dimension. A stone expulsion rate of 85.71% (42 patients) was noted in group A and 54.20% (26 patients) in group B. Group A showed a statistically significant advantage in terms of stone expulsion rate (p=0.032). Considering expulsion time in days group A demonstrated statistically significant advantage (p=0.015). Regarding age, sex, stone size and stone lateralization (right/left), there was no remarkable difference between the group A and B. No drug adverse effects were seen in both the groups. Conclusion: Tamsulosine can be used as medical expulsion therapy in lower ureteric calculi of size less than or equal to 8mm.