Tavakkoli Tabassi Kamyar, Yarmohamadi Aliasghar, Mohammadi Shabnam
Department of Urology, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
Urol J. 2011 Spring;8(2):132-6.
To investigate the success rate of internal urethrotomy when combined with corticosteroid injection in urethral scar tissue for treatment of urethral stricture.
We performed a double-blind, randomized, placebo-controlled study on 70 patients with urethral stricture, who underwent internal urethrotomy from June 2003 to July 2008. Patients were randomized into 2 groups; the experimental group (34 patients) who received triamcinolone acetonide injection and the control group (36 patients) that received an injection of sterile water after internal urethrotomy. Postoperative results were compared between two groups.
In the experimental group, 1 (2.94%), 3 (8.82%), and 2 (5.8%) patients developed infection, bleeding, and extravasation, respectively, and recurrence was noted in 12 patients. In the control group, infection, bleeding, and extravasation occurred in 2 (5.55%), 3 (8.33%), and 2 (5.55%) patients, respectively, and stricture recurred in 15 patients. There were no significant differences in stricture location as well as its etiology between the two groups (P = .672 and P = .936, respectively). Complication and recurrence rates in experimental group were lower than the control group, but the difference was not statistically significant (P = .847 and P = .584, respectively). However, time to recurrence decreased significantly in experimental group (8.08 ± 5.55 versus 3.6 ± 1.59 months) (P < .05). In our study, we did not find any complications that could be attributed to the triamcinolone acetonide injections.
It seems that steroid injection after internal urethrotomy is a safe method, which may delay the recurrence of urethral stricture.
探讨尿道内切开术联合皮质类固醇注射于尿道瘢痕组织治疗尿道狭窄的成功率。
我们对2003年6月至2008年7月间接受尿道内切开术的70例尿道狭窄患者进行了一项双盲、随机、安慰剂对照研究。患者被随机分为两组；实验组（34例患者）接受曲安奈德注射，对照组（36例患者）在尿道内切开术后接受无菌水注射。比较两组术后结果。
实验组分别有1例（2.94%）、3例（8.82%）和2例（5.8%）患者发生感染、出血和外渗，12例患者出现复发。对照组分别有2例（5.55%）、3例（8.33%）和2例（5.55%）患者发生感染、出血和外渗，15例患者出现狭窄复发。两组狭窄部位及其病因无显著差异（分别为P = 0.672和P = 0.936）。实验组的并发症和复发率低于对照组，但差异无统计学意义（分别为P = 0.847和P = 0.584）。然而，实验组的复发时间显著缩短（8.08±5.55个月对3.6±1.59个月）（P < 0.05）。在我们的研究中，未发现任何可归因于曲安奈德注射的并发症。
尿道内切开术后注射类固醇似乎是一种安全的方法，可能会延迟尿道狭窄的复发。
