Intralesional injection of mitomycin C following visual internal urethrotomy for recurrent urethral stricture: a randomized controlled study

Aim: To assess the efficacy of Intralesional injection of mitomycin C (MMC) following visual internal urethrotomy (VIU) in the management of recurrent urethral stricture. Materials: Fifty male patients diagnosed with recurrent single bulbar urethral stricture measuring less than 1.5 cm previously treated with VIU were randomly allocated into two equal groups, (Group A) planned for VIU only and (Group B) planned for VIU with intralesional MMC injection using Botox injection needle. All patients were objectively evaluated pre- and post-operatively at 3, 6, and 12 months using uroflowmetry, post-void residual urine volume, and retrograde urethrography. Results: Forty-five patients completed their follow-up in our study. Patients who underwent intralesional MMC injection showed significant improvement in uroflowmetry, post-voiding residual, and with a success rate (82.6% in Group B, compared to 50% in Group A with a highly statistically significant difference, p-value: <0.001). VIU with MMC was the only factor associated with a marked decrease in stricture recurrence ( p = 0.02) as shown in the Multivariate Cox regression analysis. Conclusion: Intralesional injection of mitomycin C seems to be a safe and effective modality in reducing the recurrent stricture rate after VIU.