A Randomized Controlled Trial Comparing Combined Spongiosum Block and Intraurethral Lignocaine with Intraurethral Lignocaine Alone in Optical Internal Urethrotomy for Urethral Stricture

Kumar, Sheetanshu; Prasad, Seema; Parmar, Kalpesh; Ganesamoni, Raguram; Batra, Yatindra Kumar

doi:10.1089/end.2011.0583

Cited by 11 publications

(6 citation statements)

References 10 publications

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“…[789] Data from the National Health Service in the UK during 2006 showed that the OIU or urethral dilatation was used in 93% of cases and urethroplasty in 7% of cases. [10] Optical internal urethrotomy has the advantage of ease, simplicity, speed, and short convalescence.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of holmium laser versus cold knife in optical internal urethrotomy for the management of short segment urethral stricture

2014

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Objectives:Sachse cold knife is conventionally used for optical internal urethrotomy intended to manage urethral strictures and Ho: YAG laser is an alternative to it. The aim of this study was to evaluate the role of urethral stricture treatment outcomes, efficacy, and complications using cold knife and Ho: YAG (Holmium laser) for optical internal urethrotomyMaterials and Methods:In this prospective study included, 90 male patients age >18 years, with diagnosis of urethral stricture admitted for internal optical urethrotomy during April 2010 to March 2012. The patients were randomized into two groups containing 45 patients each using computer generated random number. In group A (Holmium group), internal urethrotomy was done with Holmium laser and in group B (Cold knife group) Sachse cold knife was used. Patients were followed up for 6 months after surgery in Out Patient Department on 15, 30 and 180 post-operative days. At each follow up visit physical examination, and uroflowmetry was performed along with noting complaints, if any.Results:The peak flow rates (PFR) were compared between the two groups on each follow up. At 180 days (6 month interval) the difference between mean of PFR for Holmium and Cold knife group was statistically highly significant (P < 0.001). Complications were seen in 12.22% of cases.Conclusion:Both modalities are effective in providing immediate relief to patients with single and short segment (<2 cm long) urethral strictures but more sustained response was attained with Cold knife urethrotomy.

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Section: Introductionmentioning

confidence: 99%

Evaluation of holmium laser versus cold knife in optical internal urethrotomy for the management of short segment urethral stricture

2014

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“…The practice of VIU remains widespread and popular among urologists because it is easy to perform, minimally invasive, and associated with shorter procedure time and less morbidity. 12 Many studies have shown good long-term outcomes of VIU for short-segment strictures with superficial spongiofibrosis. 13,14,15 When performed under local anesthesia, it reduces time in the operating theatre, cost and hazards associated with general or spinal anesthesia.…”

Section: Resultsmentioning

confidence: 99%

A Prospective Study of Efficacy of Intracorpus Spongiosum Block in High Risk Patients for Visual Internal Urethrotomy

Malleswari¹,

K²,

Seshapani³

et al. 2015

jebmh

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To study the feasibility of intracorpus spongiosum block (ICSB) in high risk patients for Visual internal urethrotomy. METHODS: Visual Internal Urethrotomy (VIU) for urethral stricture can be performed under various types of anesthesia, including topical anesthesia and ICSB. This descriptive study was conducted in Santhiram medical college and general hospital between July 2013 and Dec 2014. Total number of 30 male patients of high risk group with American Society of Anesthesiologists (ASA) physical status grading 3 and 4 having stricture urethra were treated by VIU under ICSB. VIU was performed with a cold-cutting knife. The effect of this anesthetic technique was evaluated by Numerical Rating Scale (NRS) for pain. Out of the 30 patients five patients have no pain, twenty three patients have mild pain only. CONCLUSION: ICSB is safe and more effective than topical anesthesia alone for providing pain relief during VIU even in high risk patients

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“…At 6 months follow-up, recurrent strictures were developed in three patients in Group 1 and five patients in Group 2. [ 27 ]…”

Section: Discussionmentioning

confidence: 99%

“…[ 29 ] These can be overcome by combining topical lignocaine jelly into the urethra with ICSB as explained by Kumar et al . [ 27 ]…”

Section: Discussionmentioning

confidence: 99%

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A randomized clinical trial comparing intracorpus spongiosum block versus intraurethral lignocaine in visual internal urethrotomy for short segment anterior urethral strictures

et al. 2016

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Objectives:The primary objective was to compare the effectiveness in pain relief of intracorpus spongiosum block (ICSB) versus intraurethral topical anesthesia (TA) using 2% lignocaine jelly for performing visual internal urethrotomy (VIU) for short segment anterior urethral strictures.Materials and Methods:It was a randomized, parallel group controlled trial. Participants are adult patients with a single anterior urethral stricture up to 2 cm in length. Patients were allocated to two intervention groups with thirty patients in each group. For anesthesia of the urethra, Group 1 patients received ICSB whereas Group 2 patients received intraurethral TA using 2% lignocaine jelly before VIU. Patient discomfort was assessed with visual analog scale (VAS) during the procedure and 1 h postprocedure. The increase in pulse rate and the change in systolic blood pressure (BP) during the procedure were recorded. The procedure was considered successful if there was absence of symptoms or signs of recurrent stricture and ability to pass freely 18Fr catheter during urethral calibration at last follow-up.Results:From March 2014 to June 2015, sixty patients were randomized into two groups of thirty patients each. The mean (±standard deviation) intraoperative VAS score was 2.8 ± 1.1 in Group 1, which was significantly less (P < 0.05) than the 5.6 ± 1.7 score in Group 2. The mean 1 h postoperative VAS score was also significantly lower in Group 1 patients (1.0 ± 1.0) than in Group 2 patients (3.2 ± 1.5). The change in pulse rate was significantly greater in Group 2 (21.3 ± 10.1 beats/min) than in Group 1 (10.6 ± 4.6 beats/min, P < 0.05). The change in systolic BP was also significantly higher in Group 2 (16.3 ± 8.6 mmHg) than in Group 1 (9.1 ± 4.4 mmHg, P < 0.05). The stricture-free rate at 6-month after VIU in Group 1 and Group 2 patients were 88.5% and 89.6%, respectively.Conclusions:ICSB has better pain control with similar complication and recurrence rate than intraurethral lignocaine jelly alone in VIU.

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A Randomized Controlled Trial Comparing Combined Spongiosum Block and Intraurethral Lignocaine with Intraurethral Lignocaine Alone in Optical Internal Urethrotomy for Urethral Stricture

Cited by 11 publications

References 10 publications

Evaluation of holmium laser versus cold knife in optical internal urethrotomy for the management of short segment urethral stricture

Evaluation of holmium laser versus cold knife in optical internal urethrotomy for the management of short segment urethral stricture

A Prospective Study of Efficacy of Intracorpus Spongiosum Block in High Risk Patients for Visual Internal Urethrotomy

A randomized clinical trial comparing intracorpus spongiosum block versus intraurethral lignocaine in visual internal urethrotomy for short segment anterior urethral strictures

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