THE EFFICACY AND SAFETY OF TOPICAL TRIAMCINOLONE IN REDUCING URETHRAL STRICTURE RECURRENCE FOLLOWING INTERNAL URETHROTOMY: A SYSTEMATIC REVIEW AND META-ANALYSIS

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Published 2025-01-02
Moh. Alwi Hamzah Muhammad Risan Muhammad Jabir

Abstract

Objective: This systematic review aims to determine the efficacy and safety of topical triamcinolone in reducing urethral stricture recurrence following internal urethrotomy procedures. Material & Methods: A systematic literature search was performed in Cochrane Library, PubMed and Google Scholar with the related keywords. The statistical analysis was conducted using a Review Manager v.5.4.1. Results: We identified 6 RCTs with a total of 316 patients diagnosed with urethral stricture undergoing internal urethrotomy. The statistical analysis appeared to lower the recurrence rate significantly in patients undergoing internal urethrotomy with the adjuvant therapy of topical triamcinolone (RR 0.55, 95% CI 0.38 – 0.78, p = 0.0008). Conclusion: Additional treatment with topical triamcinolone has the benefit of declining the recurrence rate of urethral stricture following internal urethrotomy. Keywords: Triamcinolone, urethral stricture, internal urethrotomy.


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Keywords

Triamcinolone, urethral stricture, internal urethrotomy

References

Lumen N, Campos-Juanatey F, Dimitropoulos K, Greenwell T, Martins FE, Osman N, Ploumidis A, Riechardt S, Waterloos M, Barratt R, Chan G, Esperto F, Verla W, EAU Guidelines on Urethral Strictures, 2023.

Lumen N, Hoebeke P, De Troyer B, Oosterlinck W. Aetiology of urethral stricture disease: an analysis of 268 cases. Eur Urol. (Suppl) 2009;4(8):158.

Bertrand LA, Warren GJ, Voelzke BB, Elliott SP, Myers JB, McClung CD, Oleson JJ, Erickson BA, TURNS. Lower urinary tract pain and anterior urethral stricture disease: prevalence and effects of urethral reconstruction. J Urol 2015;193(1):184-9.

Santucci RA, Joyce GF, Wise M. Male urethral stricture disease. J Urol. 2007;177(5):1667-74.

F.E. Martins, S.B. Kulkarni, Textbook of Male Genitourethral Reconstruction. 2020.

Ferguson GG, Bullock TL, Anderson RE, Blalock RE, Brandes SB. Minimally invasive methods for bulbar urethral strictures: a survey of members of the American Urological Association. Urol. 2011;78(3):701-6.

van Leeuwen MA, Brandenburg JJ, Kok ET, Vijverberg PL, Bosch JR. Management of adult anterior urethral stricture disease: nationwide survey among urologists in the Netherlands. European urology. 2011;60(1):159-66.

Palminteri E, Maruccia S, Berdondini E, Di Pierro GB, Sedigh O, Rocco F. Male urethral strictures: a national survey among urologists in Italy. Urol. 2014;83(2):477-84.

Santucci R, Eisenberg L. Urethrotomy has a much lower success rate than previously reported. J Urol. 2010;183(5):1859-62.

Zhang K, Qi E, Zhang Y, Sa Y, Fu Q. Efficacy and safety of local steroids for urethra strictures: a systematic review and meta-analysis. J Endourol. 2014;28(8):962-8.

Lund L, Wai KH, Mui LM, Yeung CK. Effect of topical steroid on non-retractile prepubertal foreskin by a prospective, randomized, double-blind study. Scand J Urol Nephrol. 2000;34(4):267-9.

Verla W, Barratt R, Chan G, Dimitropoulos K, Esperto F, Yuhong Y, Greenwell T, Lumen N, Martins F, Osman N, Ploumidis A. Is a Course of Intermittent Self-dilatation with Topical Corticosteroids Superior at Stabilising Urethral Stricture Disease in Men and Improving Functional Outcomes over a Course of Intermittent Self-dilatation Alone? A Systematic Review and Meta-analysis. Eur Urol Op Sci. 2023;51:95-105.

Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, Shamseer L, Tetzlaff JM, Akl EA, Brennan SE, Chou R. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. Int J Surg. 2021;88:105906.

Deeks JJ, Higgins JP, Altman DG, Cochrane Statistical Methods Group. Analysing data and undertaking meta‐analyses. Cochrane handbook for systematic reviews of interventions. 2019:241-84.

Ergün O, Güzel A, Armağan A, Koşar A, Ergün AG. A prospective, randomized trial to evaluate the efficacy of clean intermittent catheterization versus triamcinolone ointment and contractubex ointment of catheter following internal urethrotomy: long-term results. International Urol and Nephrol. 2015;47:909-13.

Gücük A, Tuygun C, Burgu B, Öztürk U, Dede O, İmamoğlu A. The short-term efficacy of dilatation therapy combined with steroid after internal urethrotomy in the management of urethral stenoses. J Endourol. 2010;24(6):1017-21.

Hosseini J, Kaviani A, Golshan AR. Clean intermittent catheterization with triamcinolone ointment following internal urethrotomy. Urol J. 2008;5:47:909-13.

Regmi S, Adhikari SC, Yadav S, Singh RR, Bastakoti R. Efficacy of use of triamcinolone ointment for clean intermittent self catheterization following internal urethrotomy. JNMA: J Nepal Med Assoc. 2018;56(212):745.

Yeşil S, Dede O, Dede G, Nalbant İ, Zengin K, İmamoğlu MA. The long-term effect of uretral dilatation therapy combined with steroid after internal urethrotomy. Gazi Med J. 2013;5;24(3).

Mazdak H, Tolou_Ghamari Z, Khorrami A. Investigation of Triamcinolone Instillation in the Long-term Rate of Anterior Urethral Strictures' Recurrence. Curr Urol. 2020;14(4):206-10.

Virasoro R, Jordan GH, McCammon KA. Surgery for Benign Disorders of the Penis and Urethra. In: Partin AW, Dmochowski RR, Kavoussi LR, Peters CA. Campbell-Walsh-Wein urology. 12th ed. Philadelphia: Saunders/Elsevier; 2021; 8447-48.

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Department of Urology, Faculty of Medicine/Airlangga University