title: A randomized controlled trial comparing combined spongiosum block and intraurethral lignocaine with intraurethral lignocaine alone in optical internal urethrotomy for urethral stricture.
abstract: OBJECTIVE
  Optical internal urethrotomy is the most commonly performed procedure for the management of anterior urethral stricture. This study was performed to compare the safety and efficacy of spongiosum block along with intraurethral lignocaine with intraurethral lignocaine alone for optical internal urethrotomy.
  
  
  METHODS
  Fifty patients with anterior urethral stricture were prospectively randomized to undergo optical internal urethrotomy under spongiosum block along with intraurethral lignocaine (group 1=25 patients) and intraurethral lignocaine only (group 2=25 patients). The procedure-related pain was noted using the visual analogue scale. Postprocedure evaluation was performed by uroflowmetry and urethral calibration. Retrograde urethrography and micturating cystourethrography were performed as needed.
  
  
  RESULTS
  Optical internal urethrotomy was successfully completed in all patients. The mean visual analogue score for pain in group 1 (1.5 ± 1.4) was significantly lower than the score in group 2 (2.7 ± 1.8) (P=0.006). At 6 months follow-up, recurrent strictures developed in three patients in group 1 and five patients in group 2.
  
  
  CONCLUSIONS
  Spongiosum block with intraurethral lignocaine has a better anesthetic effect than intraurethral lignocaine alone for performing optical internal urethrotomy. Spongiosum block with intraurethral lignocaine is a viable alternative for regional and general anesthesia in the management of anterior urethral stricture with optical internal urethrotomy.
authors.affiliation: Department of Urology, Postgraduate Institute of Medical Education and Research, Chandigarh, India. santoshsp1967jaimatadi@yahoo.co.in
authors.forename: Santosh
authors.initials: S
authors.lastname: Kumar
authors.forename: Seema
authors.initials: S
authors.lastname: Prasad
authors.forename: Kalpesh
authors.initials: K
authors.lastname: Parmar
authors.forename: Raguram
authors.initials: R
authors.lastname: Ganesamoni
authors.forename: Y K
authors.initials: YK
authors.lastname: Batra
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000494:pharmacology; D004333:Drug Administration Routes; D006801:Humans; D008012:Lidocaine / Q000008:administration & dosage* / Q000494:pharmacology*; D008297:Male; D008875:Middle Aged; D009407:Nerve Block; D010147:Pain Measurement; D014521:Urethra / Q000187:drug effects* / Q000601:surgery*; D014525:Urethral Stricture / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000379:methods*; D055815:Young Adult
chemical_list: D000779:Anesthetics, Local; D008012:Lidocaine