COMPARISON OF STRICTURE RECURRENCE RATE BETWEEN EARLY AND LATE REMOVAL OF FOLEY CATHETER AFTER DIRECT VISION INTERNAL URETHROTOMY

Abstract

Objective: Assess the urethral stricture recurrence rates in relation to the timing of the Foley catheter removal post direct vision internal urethrotomy (DVIU), i.e., early versus late.

Methods: The cross-sectional study comparing patient groups according to the timing of Foley catheter removal was carried out at the Armed Forces Institute of Urology, Rawalpindi, for a period of six months, from September 2025 to March 2026. Male patients aged 18 to 60 with single, short-segment (<2 cm) bulbar urethral strictures were selected for enrollment through non-probability consecutive sampling. The total number of patients was 158. The patients were monitored for three months in monthly visits. Stricture recurrence was diagnosed as the return of obstructive lower urinary tract symptoms, which were validated by cystoscopy. Data were analyzed using SPSS version 27, and a chi-square test and independent sample t-test were performed with p≤0.05 set as the threshold for statistical significance.

Results: The mean age of patients was similar in both groups. Stricture recurrence was recorded in 20.3% of patients in the early removal group, while 35.4% was the figure for the late removal group. The difference in recurrence rates was statistically significant (p=0.033). The patients in the early removal group also exhibited significantly greater maximum urinary flow rates than those in the late removal group (p<0.001).

Conclusion: The early removal of the Foley catheter after DVIU is associated with a significantly lower rate of urethral stricture recurrence and better postoperative urinary flow, thus suggesting it as a favorable postoperative strategy.