URETHRAL strictures, defined by constriction of the urethra, affect 0.6% of men globally, often resulting from iatrogenic injuries linked to procedures such as transurethral resection of bladder tumours (TURBT). Among patients with non-muscle-invasive bladder cancer (NMIBC), which represents 75% of annual bladder cancer diagnoses, the risk of strictures is heightened due to frequent procedures, including catheterisation and cystoscopy.
Conventional methods to prevent strictures, such as intraurethral hyaluronic acid (HA) injections, are limited by discomfort, movement restrictions, and suboptimal contact between HA and the urethra. To address these challenges, this study explored the efficacy of a novel drug-injectable urethral catheter set (NIUS) that incorporates HA, offering improved patient comfort and enhanced clinician convenience.
The findings demonstrated that the NIUS with HA significantly reduced pain and increased patient satisfaction compared to conventional methods. Additionally, clinicians reported greater ease of use. Importantly, the NIUS showed promise in preventing grade 1 urethral strictures, a common complication following TURBT, which affects approximately 15% of patients.
HA plays a crucial role in urethral healing by creating an optimal wound environment. It promotes cell proliferation, regulates the extracellular matrix, and inhibits inflammatory responses, contributing to reduced fibrosis. Unlike traditional intraurethral injections, the NIUS facilitates better application of HA to the urethra, reducing discomfort and the risk of leakage.
Despite its promising outcomes, the study highlights limitations. The follow-up period of three months may be insufficient to assess the long-term effects on urethral stricture recurrence. Additionally, while effective for grade 1 strictures, its impact on grade 2 strictures remains inconclusive. The single-blind design could introduce subjective bias, and the findings may not generalise to other patient populations.
This study underscores the importance of addressing urethral strictures to improve survival and quality of life for NMIBC patients. The NIUS with HA represents a significant advancement in preventing these complications, warranting further research to confirm its long-term benefits and broader applicability.
Katie Wright, EMJ
Reference
Kim SJ et al. Patient satisfaction and feasibility with a novel drug-injectable urethral catheter set for hyaluronic acid administration: a multicenter randomized trial. Sci Rep. 2025;15(1):1575.
