Effect of Nurse-Led Intermittent Bladder Catheterization on Recurrence of Female Urethral Stricture following Urethral Dilatation: A Randomized Controlled Trial

Abstract

Background & Objective: Female urethral stricture (FUS) is a rare but significant cause of bladder outlet obstruction, often leading to urinary retention, recurrent UTIs and other complications. Conventional treatment like urethral dilation provides temporary relief but has a high recurrence rate. Intermittent bladder catheterization (IBC) is a promising adjunct following dilation that may reduce recurrence by maintaining urethral patency and preserving bladder health. Despite its effectiveness in managing urethral strictures, there is limited evidence regarding its implementation in female populations particularly as a nursing intervention. This study aimed to evaluate the impact of intermittent bladder catheterization (IBC) on reducing the recurrence of urethral strictures in female patients following urethral dilation.

Methodology: A randomized controlled trial was conducted at the Urology Department of Shaikh Zayed Hospital, Lahore, from May 2024 to December 2024. A total of 56 female patients (aged 35-55 years) were recruited and randomized into two groups: the intervention group (n=28), which performed IBC twice daily at home under nursing supervision, and the control group (n=28), which received standard post-dilation follow-up without IBC. Stricture recurrence was assessed over a follow up of 12 weeks through periodic catheterization using a 14Fr Nelton catheter. Relative risk and absolute risk of recurrence reduction was calculated. Confidence interval of 95% was calculated for all estimates.

Results: For data analysis, Chi-square test, independent t-test and repeated measure ANOVA were used. The recurrence rate was significantly lower in the intervention group compared to control (7.14% vs 28.57%, p = 0.03). The relative risk of recurrence was 0.25 (95% CI: 0.06–0.98), indicating a 75% reduction in recurrence with intermittent bladder catheterization.

Conclusion: Nurse-led intermittent bladder catheterization (IBC) after urethral dilation, is an effective strategy in reducing stricture recurrence among the females.