The effect of platelet-rich plasma injection on post-internal urethrotomy stricture recurrence
- 44 Downloads
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.
KeywordsUrethral stricture Internal urethrotomy Platelet-rich plasma
MR: protocol/project development, data analysis, manuscript writing/editing. RB: protocol/project development, data collection or management. RB: data collection or management, data analysis.
Compliances with ethical standards
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.
- 1.Sievert KD, Selent-Stier C, Wiedemann J, Greiner TO, Amend B, Stenzl A, Feil G, Seibold J (2012) Introducing a large animal model to create urethral stricture similar to human stricture disease: a comparative experimental microscopic study. J Urol 187(3):1101–1109. https://doi.org/10.1016/j.juro.2011.10.132 CrossRefPubMedGoogle Scholar
- 9.Gosens T, Peerbooms JC, van Laar W, den Oudsten BL (2011) Ongoing positive effect of platelet-rich plasma versus corticosteroid injection in lateral epicondylitis: a double-blind randomized controlled trial with 2-year follow-up. Am J Sports Med 39(6):1200–1208. https://doi.org/10.1177/0363546510397173 CrossRefPubMedGoogle Scholar
- 12.Peerbooms JC, Sluimer J, Bruijn DJ, Gosens T (2010) Positive effect of an autologous platelet concentrate in lateral epicondylitis in a double-blind randomized controlled trial: platelet-rich plasma versus corticosteroid injection with a 1-year follow-up. Am J Sports Med 38(2):255–262. https://doi.org/10.1177/0363546509355445 CrossRefPubMedGoogle Scholar
- 16.Amable PR, Carias RBV, Teixeira MVT, da Cruz Pacheco I, Corrêa do Amaral RJF, Granjeiro JM, Borojevic R (2013) Platelet-rich plasma preparation for regenerative medicine: optimization and quantification of cytokines and growth factors. Stem Cell Res Ther 4(3):67–67. https://doi.org/10.1186/scrt218 CrossRefPubMedPubMedCentralGoogle Scholar
- 18.Broughton G 2nd, Janis JE, Attinger CE (2006) The basic science of wound healing. Plast Reconstr Surg 117(7 Suppl):12s–34s. https://doi.org/10.1097/01.prs.0000225430.42531.c2 CrossRefPubMedGoogle Scholar
- 21.Amable PR, Carias RBV, Teixeira MVT, da Cruz Pacheco Í, Corrêa do Amaral RJF, Granjeiro JM, Borojevic R (2013) Platelet-rich plasma preparation for regenerative medicine: optimization and quantification of cytokines and growth factors. Stem Cell Res Ther 4(3):67. https://doi.org/10.1186/scrt218 CrossRefPubMedPubMedCentralGoogle Scholar
- 22.Amable PR, Carias RBV, Teixeira MVT, da Cruz Pacheco Í, Corrêa do Amaral RJF, Granjeiro JM, Borojevic R (2013) Platelet-rich plasma preparation for regenerative medicine: optimization and quantification of cytokines and growth factors. Stem Cell Res Ther 4(3):67–67. https://doi.org/10.1186/scrt218 CrossRefPubMedPubMedCentralGoogle Scholar
- 25.Gkini MA, Kouskoukis AE, Tripsianis G, Rigopoulos D, Kouskoukis K (2014) Study of platelet-rich plasma injections in the treatment of androgenetic alopecia through an one-year period. J Cutan Aesthet Surg 7(4):213–219. https://doi.org/10.4103/0974-2077.150743 CrossRefPubMedPubMedCentralGoogle Scholar