尿道狭窄症に対する経尿道的手術後の間欠的自己拡張術有用性の検討

Abstract

We retrospectively examined the restenosis rate, factors associated withrestenosis withand without intermittent self-dilatation (ISD) after transurethral surgery for urethral stricture. Male patients diagnosed with urethral stricture between July 2012 and October 2019 who underwent primary treatment by internal urethrotomy or urethral stricture dilatation were divided into two groups : those who received ISD and those who did not. Factors associated with restenosis in the ISD group were also analyzed. The total number of patients analyzed was 45, 34 (75.6%) in the ISD group and 11 (24.4%) in the no ISD group. The median age was 71 years. 19 (42.2%) had undergone transurethral surgery, 15 (33.3%) had undergone total prostatectomy, and the majority had undergone urological surgery. The hazard ratio in the ISD group was 0.1894 (95% confidence interval : 0.06749-0.5317, p＝0.001), suggesting that ISD significantly increased the time to recurrence. ISD significantly prolonged the time to recurrence. Also, restenosis was significantly more frequent when ISD was performed for less than 5 months (p＝0.00723). The results suggest that intermittent self-dilation after transurethral surgery as primary treatment for urethral stricture significantly increases the time to restenosis and that performing the procedure for more than 5 months reduces the rate of restenosis development.