Clinical features and management strategy of symptomatic spontaneous isolated celiac artery dissection

Vascular ◽  
2021 ◽  
pp. 170853812098629
Author(s):  
Xiujuan Gao ◽  
Weiping Xie ◽  
Dan Shang ◽  
Jianyong Liu ◽  
Bi Jin ◽  
...  
Keyword(s):  
Treatment Group ◽  
Conservative Treatment ◽  
Endovascular Treatment ◽  
Management Strategy ◽  
Celiac Artery ◽  
Artery Dissection ◽  
Persistent Disease ◽  
Group A ◽  
Group B

Objectives The aim of this study was to evaluate the clinical features and management strategy for patients with symptomatic spontaneous isolated celiac artery dissection (SICAD). Methods In this retrospective study, consecutive patients with symptomatic SICAD from two institutions were included. The demographics, clinical manifestations, comorbidities, imaging findings and treatment strategy selection were obtained from the medical records. The general epidemiological data, treatment regimens and clinical and follow-up outcomes were analysed. Results Patients were divided into the conservative treatment group (group A, n = 26) and endovascular treatment group (group B, n = 11). Of these 37 patients, extent of dissection in both groups included only celiac trunk (61.54%% vs. 18.18%, p = 0.03), common hepatic artery (CHA) and splenic artery (SA) (3.85%% vs. 54.55%, p = 0.001), CHA (7.69% vs. 18.18%, p = 0.57), SA (23.08% vs. 9.09, p = 0.65) and left gastric artery (LGA) (3.85% vs. 54.55%, p = 0.99). Of note, the extension of the lesion in group A was shorter than that in group B. In addition, there were significantly more type IIb in group A than in group B (42.31% vs. 9.09%, p = 0.06) and the mean length of dissection in group A was 42.3 ± 54.71 mm which was significantly shorter than that in the group B 58.45 ± 3.71 mm ( p =0.04). During a median follow-up of 11.5 months, the 1, 3, 6 and 12 month follow-ups were completed in 100% (37/37), 100% (37/37), 94.59% (35/37) and 91.19% (34/37) of patients, respectively. The cumulative rate of persistent disease stability in patients with endovascular treatment group was higher than in that conservative treatment group at the 3, 6, 9 and 12 months (50% vs. 16.67%, p = 0.001; 80% vs. 37.5%, p =0.03; 100% vs. 62.5%, p = 0.012;100% vs. 91.67%, p = 0.02 respectively). Conclusion Most symptomatic SICAD have a tendency to persistent disease stability after conservative treatment. Risk factors for failed conservative treatment were length of dissection and branch involvement. Furthermore, endovascular treatment was associated with a high technical success and persistent disease stability rate, which might be reserved for patients with failed conservative treatment.

Comparison of aortic remodelling after conservative treatment or thoracic endovascular repair in type B dissections

2019 ◽  
Vol 30 (3) ◽  
pp. 458-464 ◽  
Author(s):  
Migdat Mustafi ◽  
Mateja Andic ◽  
Oana Bartos ◽  
Gerd Grözinger ◽  
Christian Schlensak ◽  
...  
Keyword(s):  
Growth Rate ◽  
Treatment Group ◽  
Conservative Treatment ◽  
Acute Type ◽  
Type B ◽  
Descending Aorta ◽  
Group A ◽  
The Mean ◽  
Group B

Abstract OBJECTIVES Our aim was to compare aortic remodelling in type B dissections after thoracic endovascular aortic repair (TEVAR) or conservative treatment. METHODS We conducted a retrospective analysis of computed tomography (CT) data sets at dissection onset and at the last follow-up in a group with conservative (group A) and TEVAR treatment (group B). An additional analysis of the preoperative CT images was performed in patients from group A, who were converted to TEVAR during follow-up. Diameters and lengths of all aortic segments were measured and growth rates were calculated. RESULTS We included 74 patients: 50 patients in group A (follow-up time: 1625 ± 209 days) and 24 patients in group B (follow-up time: 554 ± 129 days). The mean aortic diameter growth rate was significantly higher in group A than in group B in the mid-descending aorta (A: +7 mm/year; B: −4 mm/year; P = 0.003). Length growth difference was only present in the abdominal aortic segment and was more pronounced in group A (+2 vs ±0 mm/year; P = 0.009). The conversion rate from conservative treatment to TEVAR was 36% (n = 18). A false lumen diameter of >22 mm at baseline was associated with a higher rate of conversion (P = 0.036). After conversion, the mean growth rate in the proximal descending and mid-descending aorta decreased from preoperative +11 and +18 mm/year to postoperative −9 and −14 mm/year, respectively (P < 0.001). CONCLUSIONS In acute type B dissections, TEVAR stops aortic enlargement in the thoracic aorta, but promotes distal dilatation compared to the conservative treatment group. After conversion to TEVAR in conservatively pretreated chronic type B dissections, a more pronounced diameter decrease in the descending aorta was observed than in patients treated in the acute phase.

Venous Hemodynamic Insufficiency Severity Score variation after endovascular treatment of chronic cerebrospinal venous insufficiency

2014 ◽  
Vol 30 (4) ◽  
pp. 250-256 ◽  
Author(s):  
Filippo Scalise ◽  
Eugenio Novelli ◽  
Massimiliano Farina ◽  
Luciano Barbato ◽  
Salvatore Spagnolo
Keyword(s):  
Endovascular Treatment ◽  
Severity Score ◽  
Venous Insufficiency ◽  
Color Doppler ◽  
Disability Score ◽  
Chronic Cerebrospinal Venous Insufficiency ◽  
Group A ◽  
Edss Score ◽  
Group B

Introduction Chronic cerebrospinal venous insufficiency (CCSVI) is a vascular condition characterized by anomalies of the internal jugular veins (IJVs) and/or azygos veins with disturbed flow and formation of collateral venous channels. The presence of CCSVI has been associated with multiple sclerosis (MS). Percutaneous venous angioplasty (PVA) has been proposed to improve extracranial outflow; however, a non-invasive, post-procedural follow-up outcome measure has not been established. Aim of the study To evaluate the short-term hemodynamic follow-up of CCSVI after PVA using color Doppler ultrasound (CDU) and to investigate whether hemodynamic variation correlated with clinical variation. Materials and methods Forty-five patients affected by MS with confirmed CCSVI underwent IJVs PVA. Venous hemodynamic (VH) parameters indicative of CCSVI and the Venous Hemodynamic Insufficiency Severity Score (VHISS) were evaluated by CDU at baseline and 3 months post-PVA. Concurrently, the MS-related disability status (EDSS) was evaluated. Results The VH parameters and VHISS 3 months after IJVs PVA significantly decreased: the VH parameters −32.1% and the VHISS −33.8% ( p < 0.001). The EDSS score 3 months after IJVs PVA was significantly lower than the baseline (−5.5%, p < 0.001). Using the median value of the VHISS variation as the cut-off, we were able to identify two groups of patients: responders, group A; and non-responders, group B. The EDSS score variation at 3 months was 0.310 in group A and 0.275 in group B ( p = 0.746). Conclusions CCSVI endovascular treatment can induce an improvement in VH parameters and the VHISS. The neurological disability score (EDSS) also improved after PVA; however, there was no correlation to the VHISS variation after PVA, MS type and duration.

Mid-term outcomes of symptomatic isolated superior mesenteric artery dissection with endovascular management

Vascular ◽  
2020 ◽  
pp. 170853812095011
Author(s):  
Yingjiang Xu ◽  
Xuexin Li ◽  
Dan Shang ◽  
Jianyong Liu ◽  
Bi Jin ◽  
...  
Keyword(s):  
Artery Dissection ◽  
Endovascular Management ◽  
Technical Success ◽  
Positive Events ◽  
Technical Success Rate ◽  
Line Therapy ◽  
Group A ◽  
Group B ◽  
Superior Mesenteric Artery Dissection

Objectives The clinical outcomes, safety, and efficacy of endovascular management are explored for symptomatic isolated superior mesenteric artery dissection (ISMAD). Methods In this retrospective study, 51 consecutive patients with symptomatic ISMAD received endovascular management from three institutions between January 2011 and December 2019.These patients were categorized into group A (endovascular treatment was used as the first-line therapy) and group B(endovascular treatment was used as the second-line therapy). The general epidemiological data, clinical manifestations, first-episode symptoms, treatment process, imaging findings, follow-up outcomes were analyzed from the medical records. Results A total of 51 patients with endovascular management were collected in this study. Significant differences were observed between the two groups with respect to the course (150 h vs. 57 h; p < 0.001), intestinal ischemia (26.32% vs. 6,25%; p = 0.04) and dissection length (45.26 ± 13.78 mm vs. 63.37 ± 12.73 mm; p < 0.001). Technical success rate was 90.2% (46/51). There was significant difference in the MOD (42.27 ± 23.41 min vs. 76.63 ± 28.62 min p < 0.001), MPSRT (4.67 ± 2.65 h vs. 7.32 ± 2.49 h, p = 0.02), LOS (9.52 ± 3.72 days vs. 11.86 ± 4.13 days; p = 0.01) between the two groups. The bleeding complication rate was 7.84% (one patient in group A and three patients in group B). A total of 48 (94.12%, 48/51) patients were followed up for a median of 36.51 months (range, 4–87 months). Positive events of the SMA were achieved in 81.25% (39/48), and negative events of the SMA were achieved in 18.75% (8/48) based on the follow-up contrast-enhanced CT scan. Conclusions Endovascular management of symptomatic ISMAD has a high technical success rate and efficient at controlling symptoms. Furthermore, as more positive events occur, endovascular management should be encouraged early when pain persists after conservative management or there are signs of disease progression.

scholarly journals Muller-Weiss Disease

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0024 ◽  
Author(s):  
Thos Harnroongroj ◽  
Bavornrit Chuckpaiwong
Keyword(s):  
Survival Analysis ◽  
Conservative Treatment ◽  
Demographic Data ◽  
Conservative Group ◽  
Starting Point ◽  
Data Pretreatment ◽  
Subsequent Conversion ◽  
Group A ◽  
Group B

Category: Midfoot/Forefoot Introduction/Purpose: Numerous surgical treatments for Muller-Weiss Disease(MWD) have been reported. However, up to presence, there is no study about the natural history of the conservative treatment in MWD. Our objective is to provide the survival analysis of the conservative treatment in MWD to 5-year follow up and to identify the factors that correlated to the failure of conservative treatment. Methods: This retrospective cohort review examined 32 MWD patients, age > 18 and at least Maceira’s stage 3, received conservative treatment with follow-up period to 5 years. Demographic data; pretreatment visual analogue scale(VAS) for pain on walking; foot and ankle outcome scores(FAOS); and radiographs were reviewed. A survival analysis of successful conservative treatment was done using Kaplan-Meier Curve. The “starting-point” was the time started conservative treatment. The “end-point” was the time converted to surgery. “Failure of conservative treatment” was defined as conversion to surgery due to significant pain and disability within 5-Year follow up. Patients were divided into “Successful conservative group”(A) and “Conversion to surgery group”(B). The comparison of variables between 2 groups were done to identify the factor correlated to failure of conservative treatment. Results: Mean age was 57.5±10.4 years. Average body mass index was 24.3±3.4. According to survival analysis, mean follow up period was 43.1±21.0 months . Fourteen patients(43.75%) required subsequent conversion to surgery. Survivorship of conservative treatment was 56.3%(95%CI, 47.5- 65.1) with mean survival time of 43.1 months(95%CI, 35.9- 50.3). VAS of pain on walking, FAOS in subscale of pain and quality of life(QoL) were 6.2±2.5, 58.1±24.7 and 52.8±16.6, for group A; 7.9±1.6, 33.5±16.6 and 28.9±19.0, for group B. There were significant worse of both clinical scores in group B compared to A(p<0.05). The radiographic anteroposterior Meary angle in group A and B were abducted 4.8±12.6 and 13.7±10.0. The statistical analysis showed significant more midfoot abduction in group B than A, hazard ratio 1.056(95% CI,1.003 -1.111, p=0.04). Conclusion: Survivorship of conservative treatment in MWD is only 56.3% at 5-year follow up. The failure of conservative treatment associates with degree increment of midfoot abduction.

scholarly journals Comparative study on clinical efficacy of different methods for the treatment of intramural aortic hematoma

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Junfu Luo ◽  
Wenpeng Zhao ◽  
Jiasheng Xu ◽  
Rui Zou ◽  
Kaihua Zhang ◽  
...  
Keyword(s):  
Treatment Group ◽  
Conservative Treatment ◽  
Endovascular Treatment ◽  
Intramural Hematoma ◽  
Aortic Diameter ◽  
High Morbidity ◽  
Phase Group ◽  
Aortic Intramural Hematoma ◽  
Stanford Type B

AbstractTo explore the difference of curative effect between different treatment modalities, in order to provide reference for the treatment of aortic intramural hematoma (IMH). 168 patients with aortic intramural hematoma diagnosed and treated from January 2010 to July 2020 were selected in the Second Affiliated Hospital of Nanchang University. Among them, 48 patients were diagnosed with Stanford A aortic intramural hematoma and 120 were diagnosed with Stanford B aortic intramural hematoma. According to the therapeutic methods, patients were divided into conservative treatment group and endovascular treatment group (TEVAR). For endovascular treatment group, according to the different timing of surgery, can be divided into acute phase group (onset within 72 h) and non-acute phase group (time of onset > 72 h).The clinical data and follow-up data were collected and analyzed by variance analysis and χ2 test. There were 168 patients diagnosed with aortic intramural hematoma 39 of them were (81.25%) Stanford A aortic intramural hematoma patients with pleural or pericardial effusion. For patient with Stanford A aortic intramural hematoma, endovascular treatment was performed in 15 patients (31.2%), and 33 cases (68.8%) for conservative treatment. The average follow-up (24.9 ± 13.9) was months. There were 120 patients with Stanford type B aortic intramural hematoma (71.4%), 60 patients received endovascular treatment (50%), and 60 patients (50%) received conservative treatment, with an average follow-up of (27.8 ± 14.6) months. For Stanford A type aortic intramural hematoma patients when the maximum aortic diameter ≥ 50 mm or hematoma thickness ≥ 11 mm, with high morbidity and mortality, positive endovascular treatment can reduce complications and death. For patients with Stanford type B aortic intramural hematoma, when the maximum aortic diameter ≥ 40 mm or hematoma thickness ≥ 10 mm, with high morbidity and mortality, positive endovascular treatment can reduce complications and death. Both Stanford type A and B aortic intramural hematoma patients could benefit from the endovascular treatment when the initial maximum aortic diameter is ≥ 50 mm or the hematoma thickness is ≥ 11 mm.

scholarly journals Are there any differences between the shoulder-arm sling and figure-of-eight bandage in the conservative treatment of paediatric clavicle fractures?

2021 ◽  
pp. 1-6
Author(s):  
Ali Sisman ◽  
Caner Poyraz ◽  
Ali Can Cicek ◽  
Suleyman Kor ◽  
Emre Cullu
Keyword(s):  
Muscle Strength ◽  
Conservative Treatment ◽  
Age Group ◽  
Level Of Evidence ◽  
Significant Difference ◽  
Paediatric Age ◽  
Group A ◽  
Clavicle Fractures ◽  
Group B

Purpose Clavicle fractures are treated conservatively in the paediatric age group, except in rare types of fractures. We investigated whether there was a difference between using shoulder-arm sling and figure-of-eight bandage in this age group. Methods This study was designed as a retrospective study. In all, 41 children among 53 who underwent conservative treatment with a shoulder-arm sling or figure-of-eight bandage between 2014 and 2019 were included in the study and divided into two groups. Treatment results were compared clinically with respect to pain intensity, muscle strength and radiological examinations. Results Group A comprised 20 children with a figure-of-eight bandage and group B comprised 21 children with shoulder sling. According to the Robinson classification, ten fractures were displaced in group A and 12 in group B (p = 0.647). The mean time until the first appointment after the index visit that started the management course was 25.5 days (21 to 31) in group A and 24 days (20 to 30) in group B (p = 0.129). Fracture healing was observed in all patients at the first follow-up and the treatment was discontinued. There was no difference between the groups in the muscle strength examination and shoulder joint range of movement examination at the first-year follow-up (p = 1.00). Conclusion In the paediatric age group, there was no significant difference between shoulder-arm sling and figure-of-eight bandage in the conservative treatment of clavicle fractures. Since the shoulder-arm sling is more suitable for treatment, it may be the primary preference. Level of Evidence Level III (retrospective comparative study)

scholarly journals Comparison of Epidural Steroid Injections with Conservative Management in Patients with Lumbar Radiculopathy

2014 ◽  
Vol 26 (1) ◽  
pp. 09-11
Author(s):  
Md Mahmudur Rahman ◽  
Md Imamur Rashid ◽  
Nadia Rahman ◽  
MA Shakoor
Keyword(s):  
Back Pain ◽  
Treatment Group ◽  
Conservative Treatment ◽  
Steroid Injection ◽  
Epidural Steroid Injection ◽  
Leg Pain ◽  
Therapeutic Exercises ◽  
Group A ◽  
Group B ◽  
Epidural Steroid

Pain in the back is the most common of all chronic pain disorders. Back pain and sciatica, or leg pain originating from injury to or pressure on the sciatic nerve, are major causes of disability in adults, occurring in 15% to 20% of the working-age population annually and 70% to 90% of adults at some point in their lives. Men and women are affected equally. The study was conducted prospectively in 60 patients of 18 to 60 years of age with documented chronic low back pain with sciatica. Thirty patients were treated in group-A with conservative treatment (NSAID+ therapeutic exercises+ superficial thermotherapy and ADL instruction) plus epidural steroid injection and 30 samples were treated in group B with conservative treatment only. Epidural steroid injection treatment group is significantly improved than conservative treatment group (p<0.05). There was more improvement of pain in group –A than in Group B ( p= 0.007) and SLR was more increased in group –A than group-B (p=0.03). So, epidural steroid injection is a effective treatment for lumber rediculopathy especially in acute phase. DOI: http://dx.doi.org/10.3329/medtoday.v26i1.21302 Medicine Today 2014 Vol.26(1): 09-11

Accurate diagnosis and treatment of isolated mesenteric artery dissections

Vascular ◽  
2019 ◽  
Vol 28 (2) ◽  
pp. 117-125 ◽  
Author(s):  
Chen Gang ◽  
Gao Xiujuan ◽  
Xu Yingjiang ◽  
Cui Xun ◽  
Shang Dan ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Conservative Treatment ◽  
Computed Tomography Angiography ◽  
Mesenteric Artery ◽  
Accurate Diagnosis ◽  
Diagnosis And Treatment ◽  
Initial Visit ◽  
Group A ◽  
Group B

Objectives Diagnosis and treatment of isolated mesenteric artery dissections (IMAD) are overlooked. The purpose of this study was to assess the clinical feature, possible diagnostic errors and treatment methods. Methods From January 2010 to December 2017, 99 consecutive patients who were diagnosed with IMAD on computed tomography angiography were enrolled retrospectively. Thirty-nine misdiagnosed patients, false negative, and 60 accurate diagnosis patients with revealed IMAD were compared. In addition, therapeutic schemes were evaluated. Results Ninety-nine patients participated in this study; 39 patients (34 men, 5 women; median age, 51.41 years, range 38–64 years) were included in group A who were misdiagnosed initial visit; the remaining 60 patients (52 men, 8 women; median age, 52.07 years, range 38–68 years) with IMAD who were diagnosed accurately initial visit were included in group B. Significant differences were observed between the two groups with respect to dissection length (55.26 ± 3.88 mm vs. 43.37 ± 2.75 mm; p = 0.01), and branch involvement (14 and 9, respectively; p = 0.04). Ultimately, 33 patients (group A 14 patients and group B 19 patients) underwent invasive interventional therapy, and 66 patients with conservative treatment with antithrombotic agents (group A 25 patients and group B 41 patients). A total of 86 (86.87%) had follow-up computed tomography angiography with a median duration of 24.51 months (range 2–71 months). Three patients died during follow-up. The remaining patients recovered smoothly. Conclusion Physicians should raise the awareness of IMAD and use the optimal treatment time frame. Diagnosis of IMAD depends on imaging examinations, especially computed tomography angiography. Additionally, conservative management is the most common initial treatment. For patients in whom conservative treatment fails, endovascular and/or surgery may be necessary.

scholarly journals Benefits of Etoposide Maintenance Therapy for Patients With Extensive SCLC Who Experienced PR/CR/SD After 4-6 Cycles of First-Line Chemotherapy With Etoposide Plus Cisplatin/Carboplatin

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 229s-229s
Author(s):  
Z. He ◽  
C. Zhang ◽  
Q. Wang ◽  
C. Xu
Keyword(s):  
Treatment Group ◽  
Maintenance Therapy ◽  
Maintenance Treatment ◽  
Progression Free Survival ◽  
First Line ◽  
Free Survival ◽  
Group A ◽  
Group B ◽  
Line Chemotherapy

Background: The clinical remission period of small cell lung cancer was shorter after the first-line treatment. Aim: To observe whether oral etoposide maintenance therapy can improve the progression-free survival (PFS) in patients with lung cancer who experienced complete remission (CR), partial remission (PR), and disease stabilization (SD) after 4-6 cycles of first-line chemotherapy with etoposide plus cisplatin/carboplatin. Methods: A retrospective analysis was performed on patients with ED-SCLC who were treated with etoposide (100 mg/d, iv.gtt days 1-5 with a cycle length of every 21 days) plus 4-6 cycles of cisplatin/carboplatin chemotherapy during the period from 1 January 2014 to 31 December 2016 at the Cancer Hospital affiliated with Zhengzhou University. All the patients were divided into 2 groups based on the criteria whether they had gone through maintenance therapy with etoposide: nonmaintained treatment group (NT), and maintenance treatment group (TH). The maintenance treatment group was further subdivided into the 25 mg subgroup (group A) and the 50 mg subgroup (group B) according to the maintenance dose. Analysis of 1-year progression-free survival (PFS) was conducted using the Kaplan-Meier method and Cox proportional hazards model. PFS1 was defined as the first day of first-line treatment until the disease progressed or the last follow-up time. PFS2 was defined as the first day of etoposide capsule treatment until disease progression or the last follow-up time. Results: A total of 85 patients were enrolled in this study; there were 50 patients in the NT group (58.8%) and 35 patients in the TH group (41.2%). In the TH group, there were 10 (28.6%) in the 25 mg subgroup (group A) and 25 (71.4%) in the 50 mg subgroup (group B). Detailed patient information and tumor-related parameters are shown in Table 1. For all patients, the median PFS1 in the first-line regimen with either the cisplatin or carboplatin group was 6.5 months (95% CI: 5.870-7.130) and 6.4 months (95% CI: 5.970-6.970) respectively ( P = 0.0551). Median progression-free survival for all patients and the median PFS for patients of the TH group were 6.5 months (95% CI: 6.138-6.861) and 7.2 months (95% CI: 6.702-7.698) respectively; the median PFS for the NT group, subgroup A, and subgroup B were 5.7 months (95% CI: 4.862-6.478), 6.7 months (95% CI: 6.390-7.010), and 7.4 months (95% CI: 6.386-8.474), respectively ( P = 0.0043). Median PFS2 was 2.400 months for maintenance treatment patients; the median PFS2 in the 25 mg and 50 mg groups was 2.100 months (95% CI 1.690-2.510 months) and 3.030 months (95% CI 1.937-4.123 months), respectively ( P = 0.0309). Conclusion: Use of etoposide capsules to maintain chemotherapy can significantly prolong the progression-free survival (PFS) of CR, PR, and SD in patients with extensive SCLC and improve 1-year survival; a 50-mg dose is better than 25 mg.

scholarly journals Role of intermittent self catheterization in prevention of recurrence of stricture urethra following visual internal urethrotomy: a prospective single centre study

2019 ◽  
Vol 6 (4) ◽  
pp. 1093
Author(s):  
Vijaya Kumar R. ◽  
Sachin Dharwadkar ◽  
Chirag Doshi ◽  
Akshey Batta
Keyword(s):  
Treatment Group ◽  
Urethral Stricture ◽  
Intermittent Catheterization ◽  
Control Group ◽  
Internal Urethrotomy ◽  
Stricture Urethra ◽  
Group A ◽  
Group B ◽  
Stricture Recurrence

Background: Stricture urethra is a highly recurrent disease. Various treatment modalities were used to prevent its recurrence post urethrotomy with variable success. The objective of this randomized study was to compare the stricture recurrence after optical internal urethrotomy with and without clean intermittent self catheterization in patients with anterior urethral stricture.Methods: A total of fourty patients aging 20-60 years with urethral stricture of up to 1cm and up to six months duration were selected randomly in to treatment group A (20 patients) control group B (20patients) and all patients were treated with VIU followed with indwelling catheter for 7 days. Patients with traumatic urethral stricture, congenital or malignant strictures were excluded. The treatment group A was taught to perform self clean intermittent catheterization by inserting Nelaton catheter. All patients were followed regularly at 3,6,12 months.Results: 4 (20%) patients in treatment group A had stricture recurrence while 15 (75%) out of 20 patients in control group B developed urethral stricture recurrence. In Group A 2 Patient developed stricture in first 6 months and 2 in next 6 months of follow up while in control group B 10 patients (50%)out of 20 had their recurrence in the first six months of follow-up while 5 (25%) in group B had their recurrence in the next six months of follow-up.Conclusions: Clean self intermittent catheterization is a simple, safe, cost effective and easy to perform procedure for prevention of urethral stricture with good acceptability and compliance.

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