Injection of platelet-rich plasma combined with dexamethasone with visual internal urethrotomy in treating short bulbar urethral stricture.

Purpose: To evaluate long-term urethral patency of short bulbar urethral stricture management using visual internal urethrotomy with platelet-rich plasma (PRP) in conjunction with dexamethasone injection.

Methods: This retrospective study included 78 male patients with symptomatic short bulbar urethral stricture (diagnosed by ascending urethrography) who were treated by internal urethrotomy after injection of submucosal PRP combined with dexamethasone. Every patient was monitored for urethral stricture recurrence one month after catheter removal and twenty-four months after internal urethrotomy.

Results: The etiology of urethral stricture was iatrogenic in 63 (80.8%) patients, inflammatory in 9 (11.5%) patients, and idiopathic in 6 (7.7%) patients. In terms of complications, two patients (2.7%) experienced bleeding per urethra, four patients (5.4%) had fever, three patients (4%) had hematuria, one patient (1.4%) had perineal abscess, and seven patients (9.5%) had a recurrence of stricture. The etiology of the stricture did not have any significance in patients who experienced recurrence (P = 0.77).

Conclusions: Our findings suggest a potential protective effect of PRP and dexamethasone injection at the time of internal urethrotomy also decreased the length of stricture in case of recurrence. This protective effect lasted for at least 2 years.