Effect of Mitomycin C on Anterior Urethral Stricture Recurrence after Internal Urethrotomy

Mazdak, Hamid; Meshki, Iraj; Ghassami, Fatemeh

doi:10.1016/j.eururo.2006.11.038

Cited by 135 publications

(138 citation statements)

References 8 publications

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“…According to recent studies, the efficacy of agents such as mitomycin C and triamcinolone injected into the scar tissue has been studied to decrease recurrence rates at the time of internal urethrotomy (57,58,59,60,61).…”

Section: Internal Urethrotomymentioning

confidence: 99%

Urethral Stricture is an Unpleasant Complication after Prostate Surgery: A Critical Review of Current Literature

Söğütdelen¹,

Haberal²,

Guliyev³

et al. 2016

jus

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Prostatectomy is one of the main causes of surgery in aging male population. Besides traditional techniques, novel minimally invasive approaches may also end up with certain complications following prostate surgery. Transurethral procedures may cause iatrogenic urethral trauma. Factors that may influence the development of iatrogenic endoscopic urethral strictures include "electrical dispersion" generated by unipolar current and the "diameter of the instruments" used. Those complications not only bother quality of life of the patients but also may cause various adjunctive procedures with an economical impact.Urethral stricture is the abnormal narrowing of any segment of the urethra surrounded by corpus spongiosum. It specifically means varying degrees of spongiofibrosis that refers to scarring of the corpus spongiosum (1). Any inflammation of the urethra can result in scarring that can lead to a stricture or a narrowing of the urethra. Besides prostate surgery, trauma, infections, tumors or any other cause of scarring may trigger urethral stricture (2). A recent metaanalysis including 732 patients showed that idiopathic and iatrogenic etiologies were by far the most common, accounting for 33% and 33% of all cases, respectively. Inflammatory and posttraumatic etiologies were found in only 15% and 19% of patients, respectively (3).Here, we tried to review the incidence and the basic risk factors that cause urethral stricture following prostate surgery. ÖZÜretral striktür enflamasyona bağlı olarak skarlaşma sonrası üretradaki daralmadır. Elli yaş üzeri erkeklerde benign ve malign hastalıklara bağlı olarak yapılan prostatektomiler oldukça yaygın olarak uygulanmaktadır. Prostatın transüretral rezeksiyonu sonrası farklı serilerde %19'a kadar çıkan oranlarda üretral darlık ve mesane boynu kontraksiyonu görülmektedir. Lazer prostatektomi sonrası üretral darlık prostatın transüretral rezeksiyonuna oranla daha az olarak görülmektedir, yaklaşık olarak %3,6 oranındadır. Açık prostatektomi en eski yöntem olmasına rağmen büyük prostat boyutlu hastalarda oldukça mantıklı bir alternatiftir. Açık prostatektomi sonrası yaklaşık olarak %1,9-4,8 oranında darlık bildirilmiştir. Radikal prostatektomi (RP) lokalize prostat kanseri tedavisinde bütün dünyada en yaygın olarak uygulanan yöntemdir. RP sonrası anastomoz seviyesinde mesane boynu kontraksiyonu olması iyi bilinen bir komplikasyondur ve yaklaşık olarak hastaların %0,4-32'sinde görülmektedir. Darlık büyük oranda endoskopik yöntemlerle tedavi edilmektedir, nadiren komplike olgularda bukkal mukoza greftli üretroplasti gerekebilmektedir. Anahtar Kelimeler: Üretral darlık, prostat cerrahisi, transüretral rezeksiyon, açık prostatektomi, radikal prostatektomi ABSTRACTUrethral stricture is narrowing of the urethra due to inflammation that results in scarring. Prostatectomies for benign and malign prostatic diseases are common surgical procedures among men mainly after their fifties. Urethral stricture or bladder neck contraction following transurethral resection of the prostate (TURP)...

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Section: Internal Urethrotomymentioning

confidence: 99%

Urethral Stricture is an Unpleasant Complication after Prostate Surgery: A Critical Review of Current Literature

Söğütdelen¹,

Haberal²,

Guliyev³

et al. 2016

jus

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“…[8][9][10] Results of these different treatment options remain inconsistent and, as such, none of these modalities have been widely adopted.…”

Section: Introductionmentioning

confidence: 99%

“…6,7 Current adjunctive treatments that aim to improve treatment outcomes include injection of mitomycin c and steroids. [8][9][10] Results of these different treatment options remain inconsistent and, as such, none of these modalities have been widely adopted.…”

Section: Introductionmentioning

confidence: 99%

Effect of adipose tissue-derived stem cell injection in a rat model of urethral fibrosis

Sangkum

Yafi

Kim³

et al. 2016

CUAJ

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Introduction: We sought to evaluate the therapeutic effect of adipose tissue-derived stem cells (ADSCs) in a rat model of urethral fibrosis. Methods: Eighteen (18) male Sprague-Dawley rats (300-350 g) were divided into three groups: (1) sham (saline injection); (2) urethral fibrosis group (10 μg transforming growth factor beta 1 (TGF-β1) injection); and (3) ADSCs group (10 μg TGF-β1 injection plus 2 x 10 5 ADSCs). Rat ADSCs were harvested from rat inguinal fat pads. All study animals were euthanized at two weeks after urethral injection. Following euthanasia, rat urethral tissue was harvested for histologic evaluation. Type I and III collagen levels were quantitated by Western blot analysis. Results: TGF-β1 injection induced significant urethral fibrosis and increased collagen type I and III expression (p<0.05). Significant decrease in submucosal fibrosis and collagen type I and III expression were noted in the ADSCs group compared with the urethral fibrosis group (p<0.05). TGF-β1 induced fibrotic changes were ameliorated by injection of ADSCs. Conclusions: Local injection of ADSCs in a rat model of urethral fibrosis significantly decreased collagen type I and III. These findings suggest that ADSC injection may prevent scar formation and potentially serve as an adjunct treatment to increase the success rate of primary treatment for urethral stricture disease. Further animal and clinical studies are needed to confirm these results. IntroductionUrethral stricture disease is a scarring process of the urethral mucosa and the surrounding spongy tissue of the corpus spongiosum.1 The reported estimated incidence of urethral stricture disease in an older veterans population is 0.6%.2 The incidence of urethral stricture diagnoses among Medicare beneficiaries was 1.4% in 1992 and 0.9% in 2001, respectively.3 Various modalities are available for the treatment of urethral strictures, including urethral dilatation, direct visual internal urethrotomy (DVIU), and various urethroplasty techniques. The long-term recurrencefree rates after DVIU and urethral dilatation remain quite poor. 4 Urethroplasty remains the standard of care for urethral strictures, but recurrence rates as high as 15.6% have been reported following surgery. 5 Factors predictive of treatment failure are not well-documented. 5 However, long stricture length (>4-5 cm), lichen sclerosus, infectious or iatrogenic etiologies, prior urethroplasty, and failed endoscopic therapy are risk factors of urethroplasty failure.6,7 Current adjunctive treatments that aim to improve treatment outcomes include injection of mitomycin c and steroids. [8][9][10] Results of these different treatment options remain inconsistent and, as such, none of these modalities have been widely adopted.Stem cells have the ability to undergo self-renewal and multilineage differentiation, and to form terminally differentiated cells.11 Furthermore, a number of animal studies have demonstrated that mesenchymal stem cells have antifibrotic properties that can reduce fibrosis in the lung, ki...

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“…The first or any of the repeated urethrotomies didn't have a success that exceeded 9% (Santucci and Eisenberg, 2010). There was one randomized trial testing the efficacy of Mitomycin C application in internal urethrotomy, which showed its success in reducing the rate of recurrence of strictures (Mazdak, 2007).…”

Section: Successmentioning

confidence: 99%

Urological Surgical Procedures Under Local Anesthesia

Ather¹,

Mushtaq²,

Sulaiman³

2012

Clinical Use of Local Anesthetics

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Effect of Mitomycin C on Anterior Urethral Stricture Recurrence after Internal Urethrotomy

Cited by 135 publications

References 8 publications

Urethral Stricture is an Unpleasant Complication after Prostate Surgery: A Critical Review of Current Literature

Urethral Stricture is an Unpleasant Complication after Prostate Surgery: A Critical Review of Current Literature

Effect of adipose tissue-derived stem cell injection in a rat model of urethral fibrosis

Urological Surgical Procedures Under Local Anesthesia

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