Internal urethrotomy and intraurethral submucosal injection of triamcinolone in short bulbar urethral strictures.
OBJECTIVE
In clinical practice, internal urethrotomy is an easy procedure and is offered as a first modality for treatment of short urethral strictures. Internal urethrotomy refers to any procedure that opens the stricture by incising or ablating it transurethrally. The most common complication of internal urethrotomy is stricture recurrence. The curative success rate of internal urethrotomy is approximately 20%. Triamcinolone has antifibroblast and anticollagen properties. This study evaluated the efficacy of triamcinolone in the prevention of anterior urethral stricture recurrence after internal urethrotomy.


METHODS
Fifty male patients with anterior urethral stricture were randomized to undergo internal urethrotomy with or without urethral submucosal injection of triamcinolone. Using general anesthesia urethrotomy was performed. Triamcinolone (40 mg) was injected submucosally at the urethrotomy site in 25 patients. The patients were followed for at least 12 months and the stricture recurrence rate was compared between the two groups.


RESULTS
23 patients in the triamcinolone group and 22 in the control group completed the study. There were no significant differences in the baseline characteristics of the patients or the etiology of the stricture between the two groups. Mean follow-up time was 13.7 ± 5.5 months (range: 1-25 months). Urethral stricture recurred in five patients (21.7%) in the triamcinolone group and in 11 patients (50%) in the control group (P = 0.04).


CONCLUSIONS
Injection of triamcinolone significantly reduced stricture recurrence after internal urethrotomy. Further investigations are warranted to confirm its efficacy and safety.
Mazdak
Hamid
H
Al-Zahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.
Izadpanahi
Mohammad Hossein
MH
Ghalamkari
Asghar
A
Kabiri
Mahmoud
M
Khorrami
Mohammad-Hatef
MH
Nouri-Mahdavi
Kia
K
Alizadeh
Farshid
F
Zargham
Mahtab
M
Tadayyon
Farhad
F
Mohammadi
Ahmad
A
Yazdani
Mohammad
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D007267:Injections; D008297:Male; D008875:Middle Aged; D055502:Secondary Prevention; D014221:Triamcinolone / Q000008:administration & dosage*; D014521:Urethra / Q000601:surgery*; D014525:Urethral Stricture / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*; D055815:Young Adult
D005938:Glucocorticoids; D014221:Triamcinolone