The Effects of Hyaluronic Acid and Carboxymethylcellulose in Preventing Recurrence of Urethral Stricture After Endoscopic Internal Urethrotomy: A Multicenter, Randomized Controlled, Single-Blinded Study

Chung, Jae Hoon; Kang, Dong Hyuk; Choi, Hong Yong; Jeong, Tae Yoong; Ha, U-Syn; Han, Jun Hyun; Yu, Ji Hyeong; Cho, Jeong Man; Yoo, Tag Keun; Park, Jinsung; Kim, Tae Hyo; Lee, Seung Wook

doi:10.1089/end.2012.0613

Cited by 34 publications

(23 citation statements)

References 27 publications

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“…This is not applicable to an injection of HA to an injured urethra in a rat model, but prolonged exposure to HA could have a beneficial effect. From that, Chung et al [10,11] investigated the effects of HA and carboxymethylcellulose (CMC) on the recurrence of urethral stricture after treatment with VIU and after transurethral resection of the prostate (TURP). An 18-Fr and a 22-Fr Foley catheter was inserted after VIU and TURP, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…Thus, HA/CMC was effective. It also had no noticeable side effects and helped to lessen the pain after surgery [10,11].…”

Section: Discussionmentioning

confidence: 99%

“…This report also supports our findings. Chung et al [10,11] and Kim et al [12] used the same methods for urethral instillation of HA. While the latter allowed HA exposure to the urethral mucosa for 5 min, the former did so for 24 h. Therefore, prolonging the duration of contact with the urethra increases the efficacy of the drug.…”

Section: Discussionmentioning

confidence: 99%

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The Effects of Hyaluronic Acid on Traumatic Urethral Inflammation

et al. 2019

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Purpose: This study investigated the possible beneficial effect of hyaluronic acid (HA) on traumatic urethral healing. Methods: A total of 40 adult male Wistar rats were randomized into four groups: control, sham (serum physiologic; SF group), HA 1.8%, and HA 3%. A tiny hook was introduced and drawn at the 12 o'clock position into the urethra for the SF and HA groups to create a urethral inflammation model. Either SF or HA was applied intraurethrally for 5 consecutive days. After a 15-day follow-up period (21st day of the study), penile tissue was harvested and evaluated histopathologically. Results: None of the groups showed inflammation at the end of study. Pathological findings such as calcification, hemorrhage, and stenosis were observed in the wound healing and these findings were present in all trauma groups. A significant increase in tissue thickness was observed in the group treated with saline (p = 0.004). No statistically significant difference was found in the two groups receiving HA treatment compared to the SF group. Conclusion: These data suggest that HA does not provide a beneficial effect on the connective tissue repairment when it is applied locally during the acute period of urethral injury for 5 consecutive days. There is a need for further studies in which the duration of drug use is extended or the dosage is increased.

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Section: Discussionmentioning

confidence: 99%

“…Thus, HA/CMC was effective. It also had no noticeable side effects and helped to lessen the pain after surgery [10,11].…”

Section: Discussionmentioning

confidence: 99%

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The Effects of Hyaluronic Acid on Traumatic Urethral Inflammation

et al. 2019

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“…The study of the anti-fibroblast properties of initial steroids and later mitomycin C has opened new windows of research in different surgical disciplines [16]. By delaying the healing process, the application of local steroid [17], Mitomycin C [18] or Hyaluronidase instillation [19] at the time of urethrotomy produces a better result than urethrotomy alone.…”

Section: Discussionmentioning

confidence: 99%

The Effectiveness of Tamoxifen in the Prevention of Recurrent Urethral Strictures Following Internal Urethrotomy

et al. 2018

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Objective: Tamoxifen was not used earlier in clinical practice to decrease the urethral re-stricture rate after visual internal urethrotomy (VIU). In this study, we are the first to report the use of Tamoxifen as an adjuvant therapy to decrease the re-fibrosis and stricture recurrence post-VIU. Patients and Methods: Between 2015 and 2017, 60 patients underwent VIU for post-traumatic bulbar urethral stricture ≤1 cm. They were randomly divided into 2 groups (30 patients each). The Tamoxifen group cases received Tamoxifen 10 mg twice daily for 6 months post-VIU. The control group did not receive any medications. All patients were evaluated using the IPSS score, uroflowmetry, and perineal ultrasonography preoperatively at 3 and 6 months. Results: At presentation, there was no significant difference between patients of both groups in terms of IPSS score, Qmax, stricture width, and length. At 6 months follow-up, the mean IPSS score for the Tamoxifen group was 12.3 (8–19) in comparison with 20 (12–26) in the control group (p < 0.001). The Tamoxifen group had mean Qmax 11.1 mL/s (9–14), while those of the control group had mean Qmax 8.2 mL/s (6–10; p < 0.001). Using perineal ultrasound, only stricture width showed to be significantly smaller in the Tamoxifen group (p = 0.001). Conclusion: Tamoxifen seemed to be effective in reducing the recurrence of urethral stricture post-VIU. There was a significant improvement of the clinical outcome regarding Qmax and IPSS score after Tamoxifen adjuvant therapy.

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“…4,5 However, catheterization-related urethral trauma may lead to urethral strictures, stenosis or false passages. 4,6 The occurrence rate of urethral strictures in men with NLUTD varies in the literature and has been reported to increase with time and a higher catheterization rate. 7,8 The main body of literature has been published more than a decade ago, and the reported stricture occurrence rate is generally lower (o10%) in earlier investigations [7][8][9] compared with more recent ones (~20%).…”

Section: Introductionmentioning

confidence: 99%

Urethral strictures in men with neurogenic lower urinary tract dysfunction using intermittent catheterization for bladder evacuation

2015

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Study design: Retrospective investigation. Objectives: To investigate the occurrence, characteristics and clinical consequences of urethral strictures in men with neurogenic lower urinary tract dysfunction (NLUTD) using intermittent catheterization (IC) for bladder evacuation. Setting: Spinal cord injury rehabilitation center. Methods: The patient database was screened for men with NLUTD who had presented for a routine video-urodynamic investigation between 2008 and 2012. Patient characteristics, bladder diary details, the occurrence of urethral strictures and performed urethrotomy procedures were collected from patient charts. Urethral strictures were classified using the Wiegand scoring system modified for men with NLUTD. Results: The occurrence rate of urethral strictures (that is, 25% confidence interval (CI) 21-30%) was significantly (P = 0.0001) higher in men using IC (n = 415) than in men using other bladder evacuation methods (that is, 14% CI 11-17%) (n = 629). Urethral strictures had occurred after a median 5.9 years (range 0.5-48.9 years) of IC. There was no significant (P40.08) effect of tetraplegia or catheter type on the stricture occurrence rate. Approximately one-third of the men suffering from urethral strictures underwent internal urethrotomies. The radiographic stricture severity score was not associated with the need for surgical correction of the stricture. The radiographic recurrence rate of urethral strictures in operated men was 100%, a median 14 years after the first urethrotomy. Conclusions: The occurrence rate of urethral strictures is significantly higher in men using IC than in men using other bladder evacuation methods. Every fourth men using IC may be affected by urethral strictures. However, only every third stricture may require a surgical intervention.

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The Effects of Hyaluronic Acid and Carboxymethylcellulose in Preventing Recurrence of Urethral Stricture After Endoscopic Internal Urethrotomy: A Multicenter, Randomized Controlled, Single-Blinded Study

Abstract: HA/CMC instillation during EIU may decrease the incidence of urethral stricture recurrence. In addition, the use of HA/CMC was effective in reducing pain during the early postoperative period without an adverse effect.

Cited by 34 publications

References 27 publications

The Effects of Hyaluronic Acid on Traumatic Urethral Inflammation

The Effects of Hyaluronic Acid on Traumatic Urethral Inflammation

The Effectiveness of Tamoxifen in the Prevention of Recurrent Urethral Strictures Following Internal Urethrotomy

Urethral strictures in men with neurogenic lower urinary tract dysfunction using intermittent catheterization for bladder evacuation

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