Kim Sung Jin, Chae Han Kyu, Nam Wook, Park Jong Yeon, Park Sang Hyun, Chung Jae-Seung, Oh Cheol Kyu, Yoo Sangjun, Cho Min Chul, Jeong Hyeon, Kim Seong Cheol, Park Sungchan, Seo Won Ik, Chung Jae Il, Lee Chan Ho, Min Kweonsik, Choi Jimin, Suh Jungyo, Lim Bumjin, You Dalsan
Department of Urology, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, 25440, Republic of Korea.
Department of Urology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, 457392, South Korea.
Sci Rep. 2025 Jan 10;15(1):1575. doi: 10.1038/s41598-024-84164-y.
Reducing the risk of urethral strictures after transurethral surgery for patients with bladder cancer requires effective strategies. We compared the clinical outcomes of a novel drug-injectable urethral catheter set (NIUS) with hyaluronic acid (HA) with those of the conventional intraurethral HA injection method. This six-center, prospective, randomized, single-blind trial included 192 male patients aged ≥ 20 years scheduled to undergo transurethral surgery. The primary outcome was patient-reported satisfaction. Secondary outcomes were patient-reported pain intensity, clinician-reported convenience, and urethral strictures. Cystourethroscopy was performed under direct visualization. Outcomes of the experimental (NIUS with HA) and control (HA) groups were compared using the chi-square test and t-test. The post-transurethral surgery rate was significantly higher in the experimental group than in the control group (p < 0.001). Overall, 40% and 21.7% of patients in the experimental and control groups, respectively, were very satisfied (p < 0.001). The experimental group had lower postoperative pain intensity scores (p < 0.001), higher clinician-reported convenience scores (p < 0.001), and fewer urethral strictures within 3 months postoperatively (p < 0.001) than the control group. The NIUS with HA after transurethral surgery significantly enhanced patient satisfaction, reduced pain, improved clinician convenience, and was associated with a reduction in grade 1 urethral strictures. Thus, NIUS with HA enhances post-surgery outcomes through improved patient satisfaction and reduced urethral strictures.Trial registration: Cris.nih.go.kr (KCT0007010).
降低膀胱癌患者经尿道手术后尿道狭窄的风险需要有效的策略。我们比较了一种新型可注射药物的尿道导管套装(NIUS)联合透明质酸(HA)与传统尿道内注射HA方法的临床效果。这项六中心、前瞻性、随机、单盲试验纳入了192名年龄≥20岁且计划接受经尿道手术的男性患者。主要结局是患者报告的满意度。次要结局包括患者报告的疼痛强度、临床医生报告的便利性以及尿道狭窄情况。在直视下进行膀胱尿道镜检查。使用卡方检验和t检验比较实验组(NIUS联合HA)和对照组(HA)的结局。实验组经尿道手术后的成功率显著高于对照组(p<0.001)。总体而言,实验组和对照组分别有40%和21.7%的患者非常满意(p<0.001)。与对照组相比,实验组术后疼痛强度评分更低(p<0.001),临床医生报告的便利性评分更高(p<0.001),术后3个月内尿道狭窄更少(p<0.001)。经尿道手术后使用NIUS联合HA可显著提高患者满意度、减轻疼痛、改善临床医生的便利性,并与1级尿道狭窄的减少相关。因此,NIUS联合HA通过提高患者满意度和减少尿道狭窄来改善术后结局。试验注册:Cris.nih.go.kr(KCT0007010)