The Effects of Hyaluronic Acid on Traumatic Urethral Inflammation

Yıldızhan, Mehmet; Dündar, Mehmet; Demirci, Buket; Çulhacı, Nil

doi:10.1159/000504766

Cited by 5 publications

(3 citation statements)

References 13 publications

(20 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Daily application of erythropoietin (EPO) or a single injection with botulinum toxin-A in urethral mucosa caused decrease in urethral fibrosis, with no increasing effect in high dosage EPO animals [ 29 , 30 ]. Both low and high dose daily application of sodium hyaluronate (5 days total) decreased urethral tissue thickness after 21 days [ 31 ]. Lastly, daily use of a calcium antagonist, diltiazem, for 5 days did not result in any significant histopathological changes after 21 days (connective tissue thickness, epithelial lining and degree of inflammation) [ 32 ].…”

Section: Resultsmentioning

confidence: 99%

The use of local therapy in preventing urethral strictures: A systematic review

et al. 2021

View full text Add to dashboard Cite

Background Urethral stricture disease is a common problem amongst men in Western countries often leading to a decreased quality of life. Current endoscopic treatment procedure shows an unsatisfying stricture recurrence rate which could be improved by addition of local therapies. Objectives To provide an overview of both preclinical and clinical studies in order to investigate current level of evidence on the addition of local therapy to improve urethral stricture recurrence rates after endoscopic procedures. Methods We performed a literature search in December 2020 and August 2021 using Cochrane, Embase, PubMed, Scopus and Web of Science and identified articles through combinations of search terms for ‘urethral stricture disease’, ‘stricture formation’ and ‘local interventions’. We used the SYRCLE, RoB-2 and ROBINS-I tools to assess risk of bias across included studies. We did not perform a meta-analysis due to methodological differences between studies. Results We included 32 articles in the qualitative analysis, 20 of which were preclinical studies and 12 clinical studies. Regarding preclinical articles using an animal model, nearly all interventions showed to have a positive effect on either urethral fibrosis, urethral stricture formation and/or fibrotic protein expression levels. Here, immunosuppressants and chemotherapeutics seemed most promising for possible clinical purposes. Regarding clinical studies, mitomycin-C and hyaluronic acid and carboxymethylcellulose showed positive effects on urethral stricture recurrence rates with low to intermediate risk of bias across studies. However, the positive clinical effects of mitomycin-C and steroids seemed to decrease in studies with a longer follow-up time. Conclusion Although local adjuvant use of mitomycin-C or hyaluronic acid and carboxymethylcellulose may carry clinical potential to improve urethral structure recurrence rates after endoscopic procedures, we believe that a large, well-designed RCT with a yearlong follow-up time is necessary to identify the true clinical value.

show abstract

Section: Resultsmentioning

confidence: 99%

The use of local therapy in preventing urethral strictures: A systematic review

et al. 2021

View full text Add to dashboard Cite

show abstract

“…Italiano et al 23 demonstrated preservation of the urethral lumen with adequate compliance by resecting the urethra and replacing a segment with biodegradable hyaluronate-based grafts. Yıldızhan et al 24 evaluated the effect of HA on traumatic wounds to the urethra of 40 male Wistar rats. The results were not statistically significant, probably because of the short evaluation time, but a significant increase in tissue thickness was observed in the control group treated with saline.…”

Section: Discussion/conclusionmentioning

confidence: 99%

Hyaluronic Acid Reduces Fibrosis in a Rabbit Model of Urethral Anastomosis

Buen

Ramírez-Contreras

Chejfec-Ciociano

et al. 2021

RRU

View full text Add to dashboard Cite

Introduction: Urethral stricture caused by fibrosis is a common medical condition, but topline therapy for this pathology has a high recurrence rate. This study aimed to determine the efficacy of hyaluronic acid (HA) treatment in preventing the development of fibrosis in a rabbit model of urethral anastomosis. Materials and Methods: This experimental study involved 20 rabbits. HA (0.5 mL, 25 μg/ mL) was applied in the experimental group (n = 10) during an experimental urethral anastomosis, and sterile saline (0.9%) solution was applied in the control group (n = 10). Animals underwent reoperation 12 weeks later for urethral resection. Fibrosis, inflammation, and urethral diameter were measured by two blinded pathologists at the site of the anastomosis. Results: The amount of inflammatory infiltrate was similar in both groups. The thicknesses of the collagen fiber band were 275.9 ± 62.3 and 373.4 ± 44.3 μm in the study and control groups (p = 0.001), respectively, and the urethral lumen diameters at the anastomosis site at follow-up were 2575 ± 167 and 2382 ± 214 μm, respectively (p = 0.04). Conclusion: HA treatment reduced fibrosis at the anastomosis site during this experiment; we suggest further research to corroborate its efficacy in the treatment of urethral stricture.

show abstract

“… 1 Untreated urethral stricture can lead to life-threatening complications including urinary tract infection (UTI), acute urinary retention, hydronephrosis, and periurethral abscess. 2 , 3 The prevalence of urethral stricture is 0.2%-0.6%. 2 Urethral stricture can be treated with endoscopic or open (conventional) surgeries.…”

Section: Introductionmentioning

confidence: 99%

Male Urethral Stricture in Patients with Metabolic Syndrome

Asfuroglu¹,

Balci²,

Köseoğlu³

et al. 2023

Urol Res Pract

View full text Add to dashboard Cite

Objective: Urethral stricture is characterized by fibrosis that decreases urine flow. Metabolic syndrome is a complex disorder that causes fibrosis in many organs. This study aimed to evaluate the relationship between metabolic syndrome and appearance of urethral stricture and effects of metabolic syndrome on the recurrence of urethral stricture in patients with primary urethral stricture who underwent direct visual internal urethrotomy. Materials and methods: One hundred thirty-two male patients who underwent direct visual internal urethrotomy between 2014 and 2021 because of primary urethral stricture were included. Location, length, and type of urethral stricture, time from diagnosis to surgery, postoperative follow-up, time from surgery to recurrence, and postoperative follow-up duration with a urethral catheter were retrospectively analyzed and association with metabolic syndrome was evaluated. Results: The mean age was 50.48 ± 17.94 years. Recurrence was found in 34.1% and metabolic syndrome in 27.3%. Postoperative follow-up duration was significantly longer in patients with recurrence than in those without ( P = .033). There was no statistically significant difference in terms of metabolic syndrome and postoperative urethral catheterization between patients with and without recurrence ( P = .126, P = .714, respectively). Postoperative clean intermittent self-catheterization use was found to be statistically higher in patients with recurrence than in patients without recurrence ( P = .018). Postoperative urinary tract infection rate was found to be significantly higher in patients with metabolic syndrome compared to patients without metabolic syndrome ( P = .001). Conclusion: Metabolic syndrome was not associated with recurrence. However, postoperative urinary tract infections were more common in patients with metabolic syndrome than in patients without. Clean intermittent self-catheterization used postoperatively may increase the risk of stricture.

show abstract

The Effects of Hyaluronic Acid on Traumatic Urethral Inflammation

Cited by 5 publications

References 13 publications

The use of local therapy in preventing urethral strictures: A systematic review

The use of local therapy in preventing urethral strictures: A systematic review

Hyaluronic Acid Reduces Fibrosis in a Rabbit Model of Urethral Anastomosis

Male Urethral Stricture in Patients with Metabolic Syndrome

Contact Info

Product

Resources

About