The Long-term Effect of Uretral Dilatation Therapy Combined with Steroid After Internal Urethrotomy

Abstract

Objective: To present the long-term results of hydrophilic dilatation catheter or steroid-coated hydrophilic dilatation catheter usage in the management of primary urethral stricture. Methods: Forty-one male patients with a diagnosis of primary urethral stricture shorter than 1.5 cm and no comorbities were included in this study. After application of internal uretrotomy, these patients were randomized into two groups. A steroid-coated (triamcinolone acetonide (1%) 18F hydrophilic dilatation catheter was applied to the patients in group 1 for 2 weeks and an 18F hydrophilic dilatation catheter was applied to the patients in group 2 for 2 weeks, and catheters were removed after 3 days. Uroflowmetry and recurrence rate was used in postoperative follow-ups. Results: Mean patient age were respectively 45.1±8.0 and 47±8.8(68-29) years. Urethral stricture length was evaluated for group 1 7.4±4.0 mm and group 2 7.8±4.3 mm p:0.79. All patients uroflowmetry value (Q max) were followed up on 6,12,24 and 36 month and results were evaluated. Recurrence of urethral stricture was determined in 3 (13%) patients in group 1, and 3 (15%) patients in group 2 (p<0.05) and statisticaly significant. Conclusions: As an adjuvant treatment, this method is effortless, low in complications, and hopeful. Certainly, application to larger patient populations is needed to objectively accept its efficiency.

Effect of local steroids on urethral strictures: A systematic review and meta-analysis

“…All seven included trials were identified through the literature search [ 18 19 20 21 22 23 24 ]. All trials were randomised and included the administration of steroids (triamcinolone) via a coated catheter or submucosal injection.…”

“…All seven included studies [ 18 19 20 21 22 23 24 ] were assessed for a range of risk of bias domains including random sequence generation, allocation concealment, blinding of participants and personnel, blinding of outcome assessments, incomplete outcome data, selective reporting and other bias’. A vast majority of domains across all included trials were assessed to be of unclear risk of bias due to insufficient information.…”

“…We included seven randomised trials [ 18 19 20 21 22 23 24 ] with 365 participants in total. Recurrence of urethral stricture was defined by either symptomatic or endoscopic recurrence, or the need for repeat procedure in the follow-up period.…”

“…Of the 13 patients with recorded adverse effects, 3 contracted infections, 6 experienced bleeding, and 4 had extravasation. Regmi et al [ 18 ], Ergün et al [ 19 ], Yeşil et al [ 20 ], and Hosseini et al [ 24 ] all reported no adverse events at all in their follow-up periods, while Gücük et al [ 22 ] and Mazdak et al [ 23 ] did not assess adverse event outcomes. As such, there was insufficient data to perform a meta-analysis.…”

“…Short-term data (≤12 months): We included three randomised trials [ 19 20 22 ] with 131 participants in total. At 12 months, steroids (triamcinolone) applied to the urethra via a coated catheter appear to improve the Qmax, compared to control, post DVIU, although these findings were not statistically significant (mean difference [MD], 0.82; 95% CI, -1.02–2.66) ( Fig.…”