Sapporo Medical Journal

Abstract : Internal urethrotomy is one of the most commonly performed urethral stricture surgeries. However, the efficacy of urethrotomy is still being questioned due to its high stricture recurrence rate. Several adjunctive treatments for internal urethrotomy have been widely studied to reduce the recurrence of urethral strictures, one of which is triamcinolone. We aimed to analyze the effect of triamcinolone in reducing urethral stricture recurrence rate. A systematic search was conducted in PUBMED, Science Direct, and Google Scholar databases to identify relevant randomized controlled trials (RCTs) of triamcinolone in patients with urethral stricture undergoing urethrotomy. This review has been conducted according to the PRISMA guideline and the protocol has been registered to the PROSPERO database (CRD42020202254). Six RCTs were eligible for this study. A total of 373 urethral stricture patients were included in this review. Pooled results of the included studies showed a significant difference between the triamcinolone and control group, indicating a lower recurrence rate in the triamcinolone group (OR = 0.49 95% CI 0.31-0.77, p = 0.002). Significant difference was seen in the ointment with clean intermittent catheterization (CIC) intervention subgroup (OR = 0.47 CI 95% 0.26-0.82, p=0.009), but not the submucosal injection subgroup (p>0.05). The maximum urinary flow rate (Qmax) was similar between the treatment and control groups (p>0.05) during the sixth- and twelfth-month follow-