Clean intermittent catheterization with triamcinolone ointment following internal urethrotomy

Area of Science:

• Urology
• Surgical Innovation
• Pharmacological Adjuncts

Background:

• Internal urethrotomy is a common procedure for urethral strictures.
• Recurrence of urethral strictures remains a significant clinical challenge.
• Clean intermittent catheterization (CIC) is often employed post-surgery.

Purpose of the Study:

• To evaluate the efficacy of triamcinolone ointment as a lubricant during CIC after internal urethrotomy.
• To compare the recurrence rates of urethral strictures between triamcinolone and a water-based gel.
• To assess the long-term outcomes of CIC with triamcinolone post-urethrotomy.

Main Methods:

• A randomized controlled trial involving 70 patients undergoing internal urethrotomy.
• Patients were assigned to CIC with either triamcinolone 1% ointment or a water-based gel.
• Follow-up included clinical assessment, retrograde urethrography, and urethrocystoscopy for 12 months.

Main Results:

• The triamcinolone group had a 30.0% recurrence rate versus 44.1% in the control group after the first internal urethrotomy (P = .24).
• Urethral stabilization was achieved in 88.9% of the triamcinolone group compared to 60.0% in the control group after a second procedure (P = .15).
• No significant differences in baseline characteristics or etiology were observed between groups.

Conclusions:

• Triamcinolone ointment demonstrated a trend towards reduced stricture recurrence post-internal urethrotomy.
• The observed effect was modest, suggesting a need for further research.
• The study highlights the potential, yet unconfirmed, benefit of triamcinolone in CIC regimens.