MP-02.14: The Effect of intra-corpus spongiosum mitomycin-c injection therapy combined with optic internal urethrotomy in the treatment of anterior urethral strictures: does it improve the treatment outcome?

Urology ◽  
2010 ◽  
Vol 76 (3) ◽  
pp. S20
Author(s):  
F. Claassen ◽  
S. Wentzel ◽  
G. Joubert
Keyword(s):  
Treatment Outcome ◽  
Mitomycin C ◽  
Injection Therapy ◽  
Corpus Spongiosum ◽  
Internal Urethrotomy ◽  
Urethral Strictures

Penile urethral stricture disease

2018 ◽  
Vol 12 (2) ◽  
pp. 145-157
Author(s):  
Marco Spilotros ◽  
Suzie Venn ◽  
Paul Anderson ◽  
Tamsin Greenwell
Keyword(s):  
Urethral Stricture ◽  
Lichen Sclerosus ◽  
Corpus Spongiosum ◽  
Hypospadias Repair ◽  
Internal Urethrotomy ◽  
Level Of Evidence ◽  
Urethral Stricture Disease ◽  
Urethral Strictures ◽  
Considerable Cost ◽  
The Uk

Patients affected by a urethral stricture account for a considerable cost to all healthcare systems. The estimated prevalence of all urethral stricture in the UK is 10/100,000 men during youth, increasing to about 40/100,000 by age 65 years and to more than 100/100,000 thereafter. A penile urethral stricture is a narrowing of the lumen of the urethra due to ischaemic fibrosis of the urethral epithelium and/or spongiofibrosis of the corpus spongiosum occurring within the penile urethra. Its aetiology is largely idiopathic but other important causes are failed hypospadias repair and lichen sclerosus, which account for 60% of all cases. Strictures of the anterior urethra account for 92% of cases: bulbar strictures are more frequent (46.9%), followed by penile (30.5%) and combined bulbar/penile (9.9%), that is, 40.4% of all men presenting with stricture will have a penile urethral stricture alone or in combination with a bulbar urethral stricture. There are several options for the treatment of penile urethral strictures ranging from less invasive treatments, including urethral dilatation and direct vision internal urethrotomy, to more complex augmentation graft and flap urethroplasty. The aim of the present review is to describe the aetiology and epidemiology of anterior urethral strictures and the available options reported in literature for their treatment. Level of evidence: 1a

Efficacy of Mitomycin C Combined with Direct Vision Internal Urethrotomy for Urethral Strictures: A Systematic Review and Meta-Analysis

2021 ◽  
pp. 1-14
Author(s):  
Chunru Xu ◽  
Zhenpeng Zhu ◽  
Lanruo Lin ◽  
Tongde Lv ◽  
Tianyu Cai ◽  
...  
Keyword(s):  
Success Rate ◽  
Mitomycin C ◽  
Recurrence Rate ◽  
Urethral Stricture ◽  
Risk Of Bias ◽  
Internal Urethrotomy ◽  
Randomized Controlled ◽  
Urethral Strictures ◽  
Posterior Urethra

<b><i>Background:</i></b> The high recurrence of a urethral stricture after direct vision internal urethrotomy (DVIU) has been a problem for years. Mitomycin C (MMC) is an excellent antifibrosis antigen that has been used in many fields, but its effect on a urethral stricture remains controversial. The purpose of this review was to investigate the effectiveness of MMC in reducing the recurrence rate of a urethral stricture after the first urethrotomy. <b><i>Methods:</i></b> Common databases were searched for publications prior to November 30, 2020. Randomized controlled and cohort trials were all included. Recurrence and success rates after the first urethrotomy of the posterior urethra were the main outcomes. Revman 5.3 was used for statistical analysis. Two evaluation systems, the Cochrane risk of bias tool and the Newcastle Ottawa Scale, were used to examine the risk of bias for RCTs and all studies. The quality of evidence was assessed by the Grading of Recommendations, Assessment, Development, and Evaluation standard. <b><i>Results:</i></b> Sixteen trials were included, the reporting quality of which was generally poor, and the evidence level was very low to moderate. The addition of MMC could significantly reduce the recurrence rate of urethral strictures (risk ratio [RR] = 0.42; 95% confidence interval [CI]: 0.26, 0.67; <i>p</i> = 0.0002; 9 trials; 550 participants). The results of the subgroup analysis suggested that the effect of MMC combined with DVIU was significant in short (≤2 cm) anterior urethral strictures (RR = 0.39; 95% CI: 0.20, 0.78; <i>p</i> = 0.008), &#x3e;12-month follow-up (RR = 0.45; 95% CI: 0.26, 0.76; <i>p</i> = 0.003). It also increased the success rate of the first urethrotomy procedure for posterior urethral contracture (RR = 0.74; 95% CI: 0.65, 0.84; <i>p</i> &#x3c; 0.00001; 7 trials; 342 participants). Low-dose local injection of MMC was the most commonly used method. <b><i>Conclusion:</i></b> MMC combined with DVIU is a promising way to reduce the long-term recurrence rate of a short-segment anterior urethral stricture. It also increases the success rate of the first urethrotomy of the posterior urethra. However, more high-quality randomized controlled trials are needed.

scholarly journals Efficacy of Use of Triamcinolone Ointment for Clean Intermittent Self Catheterization following Internal Urethrotomy.

2018 ◽  
Vol 56 (212) ◽  
pp. 745-748
Author(s):  
Sunil Regmi ◽  
Sunil Chandra Adhikari ◽  
Saroj Yadav ◽  
Rabin Raj Singh ◽  
Ravi Bastakoti
Keyword(s):  
Recurrence Rate ◽  
Patient Characteristics ◽  
Control Group ◽  
Internal Urethrotomy ◽  
Recurrence Rates ◽  
Urethral Strictures ◽  
Time To Recurrence ◽  
Water Based ◽  
Male Patients ◽  
Stricture Recurrence

Introduction: Internal urethrotomy is recommended for the treatment of urethral strictures shorter than 1.5 cm but has been associated with high recurrence rates. The aim of this study was to evaluate the efficacy of use of triamcinolone ointment for clean intermittent self catheterization in the prevention of urethral stricture recurrence after internal urethrotomy. Methods: Total of 60 male patients undergoing internal urethrotomy were assigned into two groups and clean intermittent self catheterization was performed using either triamcinolone ointment or a water-based gel for lubrication of the catheter in this randomized clinical trial. Clean intermittent self catheterization regimen was continued for 6 months and patients were followed for 12 months. Urethrocystoscopic evaluation was done 6 and 12 months postoperatively. Results: The recurrence rates were compared between the two groups. There were no significant differences in patient characteristics and etiology of the stricture between the two groups. There was a 6 (22.22%) recurrence rate in the patients of the triamcinolone group against 13 (46.42%) in those of the control group after the first internal urethrotomy (P=0.04). After second internal urethrotomy, the urethra was stabilized in 5 (83.3%) of the patients in the triamcinolone group and 8 (61.5%) those in the control group (P=0.05). We also found a significant correlation between recurrence and stricture length (P=0.02) but the time to recurrence was not statistically significant (P=0.16). Conclusions: The use of triamcinolone ointment in patients on CISC regimen after internal urethrotomy significantly decreased the stricture recurrence rate.

Mitomycin C in the treatment of anterior urethral strictures

2018 ◽  
Vol 15 (12) ◽  
pp. 717-718 ◽  
Author(s):  
Joon J. Park ◽  
Tricia L. Kuo ◽  
Christopher R. Chapple
Keyword(s):  
Mitomycin C ◽  
Urethral Strictures

To Compare the Recurrence Rate of Strictures after Internal Optical Urethrotomy with Intralesional Injection of Mitomycin C versus without Mitomycin C Injection in Patients Presenting with Anterior Urethral Stricture

2021 ◽  
Vol 15 (10) ◽  
pp. 2856-2858
Author(s):  
Ismat Ullah ◽  
Muhammad Waqar Shahid ◽  
Muhammad Azeem Mughal ◽  
Rahat Usman
Keyword(s):  
Mitomycin C ◽  
Recurrence Rate ◽  
Urethral Stricture ◽  
Controlled Trial ◽  
P Value ◽  
Intralesional Injection ◽  
Corpus Spongiosum ◽  
Indwelling Catheter ◽  
Significant Difference ◽  
The Mean

Background: The urethral strictures occurred due to narrowing of urethra. These may occur after an injury or ureteral or excretory system diseases, due to the injury to urothelium or corpus spongiosum that lead to the development of scar tissues. Mitomycin C can be used as chemotherapeutic agent because of its quality of being anti-tumour actions. Aim: To compare the recurrence rate of strictures after internal optical urethrotomy with intralesional injection of Mitomycin C versus without Mitomycin C injection in patients presenting with anterior urethral stricture. Study Design: Randomized controlled trial. Place and Duration of Study: Department of Urology, Lahore General Hospital, Lahore from 5th September 2016 to 5th March 2017. Methodology: Sixty male patients age 18-70 years, diagnosed with anterior (penile and bulbar) urethral stricture up to 2.0cm were included. Patients were randomly divided into two groups; Group A patients were treated with internal optical urethrotomy alone and Group B patients treated with internal optical urethrotomy with intralesional injection of Mitomycin C. After the procedure, an 18F or 20F indwelling catheter left for 7 days. After 6 months, surgical site evaluated and if stricture again developed, then recurrence labeled. Results: The mean age was 39.32±11.38 years, mean duration of stricture was 6.85±3.32 months and the mean stricture size was 1.21±0.45 cm. The recurrence occurred in 18 (30%) patients. Significant difference was noted for recurrence in both groups (p-value<0.05). Conclusion: The recurrence rate with anterior urethral stricture is significantly lower in with Mitomycin C as compared to without Mitomycin C. Keywords: Recurrence, Urethral stricture, Mitomycin C

Sign in / Sign up

Export Citation Format

Share Document