title: [Benefit of clean intermittent self-catheterization in the management of urethral strictures].
abstract: OBJECTIVE
  Urethral stenosis has a recurrent character. The urethroplasty is often proposed for repeat stenosis. This study seeks to explore the interest of clean intermittent self-catheterization in the evolution of urethral stenosis after urethrotomy.
  
  
  METHODS
  Single-center retrospective study from 2008 to 2013, concerning patients who received urethrotomy to treat urethral stenosis which was confirmed by endoscopy and a flow chart. Some accomplished self-catheterization in addition to urethrotomy to prevent recurrence. The monitoring was provided during consultation by a subjective assessment (patient and surgeon) and a flow chart. The restenosis were confirmed by endoscopy and flow chart.
  
  
  RESULTS
  Ninety-three patients treated with urethrotomy alone (50 patients) or associated with self-catheterization (43) was included. Urethral stenosis were mostly iatrogenic (75%), short <10mm (84%), single (74%) and primary (50.5%). Mean follow-up was 99.3±72.8 weeks. Eighteen patients (19%) had symptomatic recurrence suspected by flow chart with a mean Qmax at recurrence was 6.25±2.8mL/s (P<0.001), 8 in urethrotomy group and 10 in the urethrotomy+self-catheterization group. Recurrence rates were comparable in the 2 groups, urethrotomy (16%) urethrotomy+self-catheterization (23%) (P=0.46). The mean time to recurrence was 81.1±87 weeks and was different in the 2 groups: 76.8±76.3 weeks in urethrotomy group, 83.3±93.9 in urethrotomy+self-catheterization group (P=0.014). An analysis recurrence for the primitive urethral stenosis showed that the recurrence rate was not statistically different: 18% for urethrotomy+self-catheterization group vs 14% for urethrotomy group. An analysis of recurrent relapses for urethral stenosis showed a rate of 26%, comparable in the 2 groups (P=1).
  
  
  CONCLUSIONS
  After urethrotomy, urethral stenosis recurs in 1 patient over 5, after 18 months especially if they were complicated (multiple, recurrent, extended). Self-catheterization do not provide benefit in terms of recurrence (for the general population and for primitive urethral stenosis) compared to only urethrotomy but seem to extend the time without recurrence (76.8 weeks vs 83.3 weeks).
  
  
  METHODS
  5.
authors.affiliation: Service d'urologie, nouvel hôpital civil, 1, place de l'Hôpital, 67091 Strasbourg, France. Electronic address: pmouracade@hotmail.com.
authors.forename: T
authors.initials: T
authors.lastname: Tricard
authors.affiliation: Service d'urologie, nouvel hôpital civil, 1, place de l'Hôpital, 67091 Strasbourg, France.
authors.forename: E
authors.initials: E
authors.lastname: Padja
authors.affiliation: Service d'urologie, nouvel hôpital civil, 1, place de l'Hôpital, 67091 Strasbourg, France.
authors.forename: F
authors.initials: F
authors.lastname: Story
authors.affiliation: Service d'urologie, nouvel hôpital civil, 1, place de l'Hôpital, 67091 Strasbourg, France.
authors.forename: Y
authors.initials: Y
authors.lastname: Saeedi
authors.affiliation: Service d'urologie, nouvel hôpital civil, 1, place de l'Hôpital, 67091 Strasbourg, France.
authors.forename: P
authors.initials: P
authors.lastname: Mouracade
authors.affiliation: Service d'urologie, nouvel hôpital civil, 1, place de l'Hôpital, 67091 Strasbourg, France.
authors.forename: C
authors.initials: C
authors.lastname: Saussine
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D057928:Intermittent Urethral Catheterization; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D012648:Self Care; D014525:Urethral Stricture / Q000150:complications / Q000628:therapy*; D055815:Young Adult
keywords: Auto-dilatation; Self-catheterization; Sténose de l’urètre; Urethral stenosis; Urethrotomy; Uretrotomie