LONG-TERM RESULTS OF INTERMITTENT LOW-FRICTION SELF-CATHETERIZATION IN PATIENTS WITH RECURRENT URETHRAL STRICTURES

Objective To ascertain the duration of intermittent low-friction self- catheterization (ILSC) required to cause stricture stabilization. Pati ents and methods Over a 4 year period, 101 patients with a median age of 62 years (range 16-85) with recurrent urethral strictures were recr uited to the trial. All the strictures were treated by internal urethr otomy and the patients were then randomized to perform ILSC twice week ly for either 6 months (group 1) or 36 months (group 2). Out-patient f ollowup with urinary now rate was initially at 1 month and then at 3 m onthly intervals. Stricture recurrence rates were compared between the two groups. Results Of 101 patients, seven failed to attend after the first out-patient appointment. A further 21 died of unrelated disease whilst on ILSC (although 13 had been followed up for at least 24 mont hs and so were included in the analysis). The median follow-up was 67 months (range 24-78). Ten patients in group 2, who had suffered from r ecurrent strictures, refused to stop catheterizing at the appointed ti me and all remain stricture-free on permanent ILSC. Of the remaining 7 6 patients, 48 catheterized for 6 months and 28 patients performed ILS C for 12 to 36 months (nine stopped earlier than intended). Forty per cent of patients who stopped at 6 months developed a recurrence compar ed with 14% who catheterized for more than 12 months (P < 0.05) (chi-s quare test with Yates' correction). Conclusions Our results indicate t hat ILSC is safe and effective in preventing stricture recurrence in t he long term. The recurrence rate of urethral strictures was significa ntly lower when ILSC was continued for more than 12 months compared wi th ILSC that was stopped at 6 months. We conclude that catheterization for at least 1 year is required to achieve adequate urethral stabiliz ation.