title: Catheter dwell time and diameter affect the recurrence rates after internal urethrotomy.
abstract: OBJECTIVE
  Cold-knife direct vision internal urethrotomy (DVIU) is frequently used as the first-line treatment for urethral stricture disease. Although the steps of the procedure are defined in detail, the duration of catheterization and the diameter of the catheter to be used after the operation are not clearly defined. The aim of this study is to evaluate the effects of catheter dwell time and diameter on recurrence rates of urethral stricture disease after DVIU.
  
  
  METHODS
  Data of 193 consecutive treatment naïve bulbar urethral stricture patients who underwent DVIU between January 2009 and June 2013 were retrospectively analyzed. Patient demographics and stricture characteristics were noted. Catheter dwell times were grouped as <5 and ≥5 days. The diameters of catheters used were 16, 18 and 22 Fr. The association between recurrence rates, catheter dwell times, and diameter were evaluated with Tukey's test and Pearson's correlation test, respectively.
  
  
  RESULTS
  Overall 193 patients with a mean age of 64.51±12.99 (range: 17 to 85) years were enrolled in the study. Urethral stricture disease recurred in 45 (23.31%) patients within the first year after DVIU. Mean duration of catheterization was 7.47±4.03 and 4.79±1.94 days in patients with and without recurrences, respectively (p=0.0001). Catheter dwell times for ≥5 days were also associated with increased recurrence (p=0.0001). Of the patients with recurrent strictures, 16, 18 and 22Fr catheters were placed in 22.22%, 20% and 57.78% of the patients, respectively. Increased catheter diameter was also associated with higher recurrence rates (p=0.004).
  
  
  CONCLUSIONS
  Shortening the postoperative duration of catheterization and decreasing the catheter size may result in improved recurrence rates after DVIU. Further prospective randomized trials are necessary to confirm these findings.
authors.affiliation: Clinic of Urology, Bağcılar Training and Research Hospital, İstanbul, Turkey.
authors.forename: Emrah
authors.initials: E
authors.lastname: Yürük
authors.affiliation: Clinic of Urology, Bağcılar Training and Research Hospital, İstanbul, Turkey.
authors.forename: Serhat
authors.initials: S
authors.lastname: Yentur
authors.affiliation: Clinic of Urology, Bağcılar Training and Research Hospital, İstanbul, Turkey.
authors.forename: Ömer Onur
authors.initials: ÖO
authors.lastname: Çakır
authors.affiliation: Clinic of Urology, Bağcılar Training and Research Hospital, İstanbul, Turkey.
authors.forename: Kasım
authors.initials: K
authors.lastname: Ertaş
authors.affiliation: Clinic of Urology, Bağcılar Training and Research Hospital, İstanbul, Turkey.
authors.forename: Ege Can
authors.initials: EC
authors.lastname: Şerefoğlu
authors.affiliation: Clinic of Urology, Bağcılar Training and Research Hospital, İstanbul, Turkey.
authors.forename: Atilla
authors.initials: A
authors.lastname: Semerciöz
keywords: Catheter; internal urethrotomy; urethral stricture