Vol. 7, Issue 1, Part A (2025)

Urethral stricture is a common urological condition, with optical internal urethrotomy (OIU) being the most widely used minimally invasive treatment. However, postoperative recurrence remains a significant challenge. This quasi-experimental study, conducted in the Department of Urology, Sir Salimullah Medical College Mitford Hospital, Dhaka, from March 2022 to August 2023, aimed to compare the effectiveness of oral steroid therapy (Deflazacort) versus clean intermittent self-catheterization (CISC) in reducing stricture recurrence following OIU. Seventy male patients with short-segment (≤1.5 cm) bulbar urethral strictures were enrolled and divided into two groups. Group A received oral Deflazacort (6 mg twice daily for 2 weeks, then once daily for 2 weeks), while Group B performed CISC using a 16 Fr Nelaton catheter according to a structured schedule. Patients were followed up at 3, 6, and 12 months postoperatively. The mean age of patients in Group A and Group B was 38.6±12.3 and 39.0±12.9 years, respectively (p=0.89). Preoperative maximum urinary flow rates were comparable (7.2±1.2 vs 7.1±1.2 mL/sec). Postoperatively, Group A showed significantly higher flow rates at 3 months (26.9±1.7 vs 25.9±2.4 mL/sec, p=0.042), 6 months (23.9±1.6 vs 22.9±2.4 mL/sec, p=0.046), and 12 months (22.2±1.7 vs 21.1±2.1 mL/sec, p=0.016). Recurrence of stricture was significantly lower in Group A compared to Group B (5.7% vs 25.7%, p=0.045). The study concludes that oral steroid therapy with Deflazacort is more effective than CISC in preventing recurrence of urethral stricture following OIU.