內視鏡尿道切開術後灌注絲裂黴素C預防尿道狹窄復發
賴明坤 楊淵隆 陳腓力
宜蘭天主教靈醫會羅東聖母醫院 泌尿科
Instillation of Mitomycin C after Internal Urethrotomy to Prevent Recurrence of Urethral Stricture
Ming-Kuen Lai, Yuan-Lung Yang, Fee-Le Chen
Division of Urology, Camillians Saint Mary’s Hospital Luodong
Taiwan
Purpose: Use of mitomycin C (MMC ) urethral instillation to prevent recurrence of urethral stricture after internal urethrotomy.
Introduction: During the repair of the injured part of urethra, stricture in urethra occurs owing to the increase in urethral scar tissue. Topical administration of MMC, which is an antitumor antibiotic isolated from Streptomyces caespitosus, inhibits fibroblast proliferation and prevents scar formation. In the original animal study using MMC to prevent urethral stricture, MMC was administered to the injured urethra in the form of irrigation (Ref 1). Hamid Mazdaka et al reported that urethral submucosal injection of MMC can effectively reduce recurrence of stricture (Ref 2). However, submucosal injection is cumbersome and might cause further urethral injury. We modified the technique similar to the original animal experiment.
Materials and Methods: Two male patients with anterior urethral strictures were treated with optic internal urethrotomy. Foley balloon was distended to 30 ml and pulled against the bladder neck. Then 10 mg of MMC was instilled to the operative site with a Nelaton catheter passed along the Foley catheter while a rubber band was wrapped around the coronal sulcus to prevent leakage. The instillated MMC stayed in the urethra for 30 minutes （Fig）. The patients were followed up with uroflowmetry and bladder residual urine.
Results: Both patients enjoyed excellent results postoperatively.
Conclusions: Our modified method is much easier to apply and seemed to have similar result.