The efficacy of intraurethral lidocaine in optical internal urethrotomy for anterior urethral stricture: a multicenter study.

BACKGROUND: Male anterior urethral strictures can be treated successfully with the help of optical internal urethrotomy (OIU) and is usually performed under general or regional anesthesia. In this study, we determined the efficacy of intraurethral lidocaine in OIU for anterior urethral stricture in an outpatient setting.

METHODS: A total 157 patients with anterior urethral strictures underwent OIU under local urethral anesthesia with lidocaine. Optical urethrotomy was performed with a cold-cutting knife. Visual analogue scale (VAS) was used to evaluate patient discomfort and pain levels.

RESULTS: Using local anesthesia with lidocaine 2%, internal urethrotomy under vision was successfully completed in 151 of 157 patients. The overall success rate 96.1%. A total of 125 patients experienced mild, 26 patients moderate and 6 patients severe pain. The procedure was not completed in six patients because of severe pain. These patients went on OIU under general anesthesia. 18 (11.4%) recurrent strictures were seen during at least 6 months of follow-up.

CONCLUSIONS: Topical intraurethral lidocaine is a simple and efficacious anesthesia technique for surgical procedures on the anterior urethra. It is a safe, cost-effective and a well tolerated procedure. OIU under topical anesthesia can be easily performed and satisfactorily completed in an outpatient setting. It is anesthetic efficacy and reasonable success rate when compared with the other anesthetic techniques may provide an alternative approach in the management of urethral strictures.