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Direct visual internal urethrotomy (DVIU) is a minimally invasive treatment for short segment urethral strictures, but has a high recurrence rate of 30-60%. Open urethroplasty is more invasive but has a lower recurrence rate of 10-20% and is the gold standard treatment. Applying 0.1% tacrolimus ointment after DVIU may reduce wound contraction and the chance of recurrent strictures compared to DVIU alone. This study aims to assess the success of DVIU combined with tacrolimus ointment as a primary treatment for short segment urethral strictures.
USD.pptx
- 1. Current clinical practice Hypothesis Short segment stricture DVIU ¨CPrimary Treatment - Minimally invasive - Short duration (30-45 min) - lesser risk of complication - Very less cost Vs Open - Fast recovery(1 day) - 30% -60% recurrence(Higher) Short segment stricture DVIU ¨CPrimary Treatment Tacrolimus ointment application Less chance of recurrent stricture -SEACHANGEIN MANAGEMENT Open urethroplasty ¨C GOLD STANDARD -Morbid procedure(3-4 hours) -Less cost effective -Risk of complications more. -Recovery (3-6 weeks). -Low Recurrence(10-20%) Decreased wound contraction If Fails
- 2. Patient in urology opd with voiding Lower urinary tract symptoms Evaluated with- - AUA symptom score score - Uroflow - USG PVR - RGU - Urethrocystoscopy Treated with Direct visual internal Urethrotomy (DVIU) Diagnosed as Urethral stricture disease Followed by topical application of 0.1% Tacrolimus ointment Reassessment for success of DVIU +Tacrolimus as treatment modality Compared with Established success rate of only DVIU as treatment modality RESULTS Review of Literature Exclusion and inclusion criteria