Local injection of platelet-rich plasma (PRP) is postulated to work by delivering growth factors and cytokines that recruit healer cells and enhance recovery process at the injection site. As new scar formation leads to stricture recurrence after internal urethrotomy, we proposed to improve post-internal urethrotomy stricture recurrence rate by injecting local submucosal PRP at the time of urethrotomy.
From July 2015 to June 2018, 87 male patients with symptomatic bulbar urethral stricture (diagnosed by retrograde urethrography) randomized into two groups of internal urethrotomy and submucosal normal saline injection (control group, 43 patients), and internal urethrotomy with submucosal autologous platelet-rich plasma injection (PRP injection group, 44 patients). According to the endpoint, which happened sooner, each patient was followed at 3-month intervals for 2 years after internal urethrotomy or until urethral stricture recurrence.
Twelve-month recurrence rates were 26.82 and 9.09% in the control and the PRP injection groups, respectively (p 0.032). After 2 years of follow-up, stricture recurrence was identified in 18 (43.90%) and 9 (21.95%) patients in the control and the PRP injection groups, respectively (p 0.34).
In our study, submucosal PRP injection at the site of internal urethrotomy decreased the rate of stricture recurrence a year after the intervention. This protective effect lasted for 24 months, at least. Submucosal PRP injection at the time of internal urethrotomy also decreased the length of stricture in case of recurrence.
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Conflict of interest
The authors whose names are listed certify that they have no affiliations with or involvement in any organization or entity with any financial interest, or non-financial interest in the subject matter or materials discussed in this manuscript.
Research involving human participants and/or animals
The protocol of this research was approved by the research ethics committee of Shiraz University of Medical Sciences, Shiraz, Iran on April 7, 2015. All therapeutic and diagnostic interventions performed in this study were in accordance with the ethical standards of the institutional (Shiraz University of Medical Sciences) and national (Iran) research committee, and with the 1964 Helsinki Declaration of the World Medical Association and its later amendments. Written informed consent was obtained from all participants before entering the study.
Data sharing statement
Data are available for bonafide researchers who request it from the authors.
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Rezaei, M., Badiei, R. & Badiei, R. The effect of platelet-rich plasma injection on post-internal urethrotomy stricture recurrence. World J Urol 37, 1959–1964 (2019). https://doi.org/10.1007/s00345-018-2597-8
- Urethral stricture
- Internal urethrotomy
- Platelet-rich plasma