Abstract
Objective
To assess feasibility and efficacy of local topical urethral anesthesia at optical
internal urethrotomy (OIU) in patients with anterior and posterior urethral strictures
at outpatient clinic.
Methods
One hundred and twenty eight patients were prospectively randomized to perform OIU
with intraurethral prilocaine solution (group 1 = 64 patients) or intraurethral lidocaine
gel (group 2 = 64 patients). Visual analog scale was used for procedure related pain
evaluation at the beginning, during, and one hour after the procedure. All patients
had follow-ups for a minimum of 12 months. Treatment failure was defined as Qmax < 12ml/sec at uroflowmetry and observed urethral stricture on
cystoscopy.
Results
The overall success rate of the OIU was 75.8%. The intraoperative mean visual analogue
score in group 2 (5,1 ± 1,77) was significantly higher than the group 1 (3.7 ± 1.9)
(P = 0.0001). The median time to stricture recurrence was 9.2 months (range 1-13 months).
Stricture recurrences were noted in 15 patients in Group 1 and 16 patients in Group
2 during the follow-up period.
Conclusion
Prilocaine solution as a local anesthetic is a better option than intraurethral lidocaine
gel in the OIU procedure and allows successful OIU to be performed in outpatient clinic.
It can be preferred as a local anesthetic for OIU, particularly in unfit patients
for general/regional anesthesia. Although it provides successful pain relief, it still
cannot prevent experiencing moderate or severe pain in a group of patients. More studies
about more effective local anesthetics for pain relief during OIU at the outpatient
clinic are required.
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Article info
Publication history
Published online: September 30, 2022
Accepted:
August 23,
2022
Received:
April 29,
2022
Footnotes
Informed consent: Informed consent was obtained from all individual participants included in the study.
Financial Disclosure: There are no financial conflicts of interest to disclose.
Conflict of interest: The authors declare that they have no conflict of interests.
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
