Effects of hyaluronic acid and carboxymethylcellulose on urethral stricture after transurethral resections of the prostate for benign prostatic hyperplasia: a multicenter, single blinded, randomized controlled study.
OBJECTIVE
To evaluate the effect of hyaluronic acid (HA) and carboxymethylcellulose (CMC) instillation after transurethral resection of the prostate (TURP) on preventing urethral stricture.


METHODS
A total of 180 patients underwent TURP for benign prostatic hyperplasia. Recruited patients were randomly divided into two groups: Groups A and B. Patients in group A (90 patients, experimental group) received HA/CMC instillation, and patients in the group B (90 patients, control group) received lubricant instillation after TURP. Each patient was evaluated at 4 weeks (V1), 12 weeks (V2), and 24 weeks (V3) after the surgery. The effectiveness of HA/CMC instillation was evaluated based on the International Prostate Symptom Score/Quality of Life, peak urine flow rate, voided volume, and postvoid residual volume. The visual analogue scale (VAS) pain score and degree of satisfaction were also determined for each participant.


RESULTS
Among 180 initial participants, 80 patients in group A and 81 patients in group B had completed the experiment. VAS pain scores were 0.75±0.75 and 1.75±1.37 (P<0.001), and degrees of satisfaction were 0.63±0.66 and 0.91±0.51 in group A and group B at 1 month after surgery (P=0.002). By retrograde urethrography, urethral stricture after TURP was seen in 1 of 80 subjects in group A and 7 of 81 subjects in group B.


CONCLUSIONS
HA/CMC instillation after TURP decreased the incidence of urethral stricture. In addition, HA/CMC was effective at reducing pain during the early postoperative period, with no adverse effects.
Department of Urology, Hanyang University College of Medicine, Seoul, Korea.
Jae Hoon
JH
Chung
Dong Hyuk
DH
Kang
Hong Sang
HS
Moon
Tae Yoong
TY
Jeong
U-Syn
US
Ha
Jun Hyun
JH
Han
Ji Hyeong
JH
Yu
Jinsung
J
Park
Jeong Man
JM
Cho
Tag Keun
TK
Yoo
Tae Hyo
TH
Kim
Seung Wook
SW
Lee
D002266:Carboxymethylcellulose Sodium / Q000627:therapeutic use*; D002404:Catheterization; D006801:Humans; D006820:Hyaluronic Acid / Q000627:therapeutic use*; D008297:Male; D011183:Postoperative Complications / Q000209:etiology; D011470:Prostatic Hyperplasia / Q000601:surgery*; D016037:Single-Blind Method; D020728:Transurethral Resection of Prostate / Q000009:adverse effects*; D016896:Treatment Outcome; D014525:Urethral Stricture / Q000188:drug therapy* / Q000209:etiology*
D006820:Hyaluronic Acid; D002266:Carboxymethylcellulose Sodium