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Management - Dilation

Dilation was known to ancient civilizations.  It was considered the standard treatment for managing strictures of the urethra over centuries. The aim dilation is to stretch the scar without bleeding so the narrow urethral lumen is stretched temporarily and the patient can void well. Dilation needs to be repeated either daily or on alternate days or once a week or once a month or once a year. The surgeon hopes that the interval between dilation is slowly stretched in this fashion. Dilation rarely cures strictures. It can cure transparent thin membrane like strictures and they are rare in nature. Dilation may cause pain, fever and bleeding due to false passages.

Management - Self Cath

Many centers advocate a policy of single DVIU followed by self intermittent catheterization. This policy is useful in those patients who are unfit for surgery, those who refuse surgery, after filled complex urethroplasty where the surgeon does not want to perform more surgery.

Self intermittent catheterization is performed by the patient daily initially and slowly the interval is increased to once in a week to once a month.A 14F Nelaton catheter is used by many patients.They wash their hands with soap and water lubricate the catheter Xylocaine jelly and introduce it through the meatus into the bladder after use the catheter  is stored in jar of antiseptic solution such as Betadine.

Some patients develop restricture quickly and the patients have difficulty in maintaining caliber themselves.  Recurrent urine infection dysuria and bleeding could be the possible complications of self cath over a long period of time the length of the stricture may increase and the spongio fibroses becomes severe due to repeated trauma.

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