AB013. SOH24AB_098. The role of Otis urethrotomy in addressing recurrent urinary tract infections and chronic urethral symptoms in women: a comprehensive review

Background: Urinary tract infections (UTIs) remain a persistent challenge in women, necessitating effective interventions. This review explores the efficacy of internal urethrotomy, specifically utilizing the Otis urethrotome, in managing recurrent UTIs and chronic urethral symptoms.

Methods: A thorough review of literatures on MEDLINE database was conducted, employing keywords such as female internal urethrotome, UTI, and female meatotomy. The selected studies included diverse patient populations, encompassing adult women and girls, with variations in treatment protocols and follow-up durations.

Results: Studies revealed significant subjective improvement post-Otis urethrotomy, with positive outcomes sustained at six months (90%), 12 months (85%), and beyond two years (75%). The procedure exhibited prophylactic potential, with a 72% infection-free rate in the first postoperative year for recurrent bacterial cystitis. Internal urethrotomy was deemed valuable for chronic urethritis, achieving a favorable postoperative result in 61% of cases. Notably, an extensive study on 205 women reported excellent results in 52% and good results in 30% during a follow-up exceeding six months, eliminating the need for postoperative urethral dilatation. However, some studies suggested no advantage of Otis urethrotomy in routine treatment for lower urinary tract symptoms.

Conclusions: The collective evidence suggests that internal urethrotomy offers both subjective and objective improvements in women with recurrent UTIs and chronic urethral symptoms. The procedure emerges as a valuable therapeutic option, providing lasting benefits. Careful consideration is warranted due to outcome variations and the efficacy of alternative interventions. Future research should emphasize protocol standardization and further exploration of the long-term impacts of internal urethrotomy in this patient population.

Keywords: Female internal urethrotome; female internal urethrotomy and urinary tract infection (female internal urethrotomy and UTI); female meatotomy; female meatotomy and UTI; urinary tract infection (UTI)