Does mitomycin-C and triamcinolone injection therapy during optical urethrotomy able to reduce the recurrence of urethral stricture? A comparison study.

Abstract

Background: Male urethral stricture is one of the common diseases. Stricture disease may lead to severe complications which badly affect the quality of life like urinary tract infection, vesical stones, urethrocutaneous fistulas, sepsis, and finally renal impairment. Due to its high recurrence rates, it is one of the most complex and challenging issues in urological practice. The aim of the study is to evaluate the effect of intralesional mitomycin-C and triamcinolone after direct visualized internal urethrotomy on the recurrence of urethral stricture. Method and patient: An observational comparative study that was conducted between September 2019 and October 2021. It included 34 male participants with urethral stricture. Twelve participants were in group A in whom participants underwent direct visualized internal urethrotomy with no adjuvant treatment, 11 participants were in group B who underwent direct visualized internal urethrotomy with mitomycin-C injection and another 11 patients underwent direct visualized internal urethrotomy with triamcinolone injection were in group C. Patients were selected from outpatient clinic. Patients with idiopathic causes of stricture, traumatic non-instrumental or post-urethroplasty stricture, recurrent stricture and stricture more than 15 mm in length were excluded from the study. Follow up was done at 3, 6 and 12 months post-operatively. Result: In this study, only one patient among 11 who received mitomycin-C injection (9.1%) had recurrence while 2 out of 11 patients who received triamcinolone (18.2%) had recurrence. Six out of 12 patients (50%) who undergone direct visualized internal urethrotomy only had recurrence. Adjuvant therapy decreased the recurrence rates, and the results were statistically significant. No correlation between stricture recurrence time and the type of adjuvant therapy used was found. Relationship between recurrence rate of stricture and various other variables such as age of the patient, length of stricture, stricture site and etiology were not observed in the study as the p-value was greater than 0.05. Conclusions: Intralesional injection of either Mitomycin-C or Triamcinolone reduces the recurrence rate of urethral strictures with statistically significant results.