Mp32-09 Six-Month Report Assessing the Feasibility and Effectiveness of Amniotic Membrane Injections in Patients With Short, Anterior, Urethral Strictures

You have accessJournal of UrologyReconstruction: Urethral Reconstruction (Including Stricture) II (MP32)1 May 2024MP32-09 SIX-MONTH REPORT ASSESSING THE FEASIBILITY AND EFFECTIVENESS OF AMNIOTIC MEMBRANE INJECTIONS IN PATIENTS WITH SHORT, ANTERIOR, URETHRAL STRICTURES Nicholas Pryde, Jack Vernocke, Aron Liaw, Michael Sessine, and Nivedita Dhar Nicholas PrydeNicholas Pryde , Jack VernockeJack Vernocke , Aron LiawAron Liaw , Michael SessineMichael Sessine , and Nivedita DharNivedita Dhar View All Author Informationhttps://doi.org/10.1097/01.JU.0001008816.80828.35.09AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Endoscopic urethral stricture treatment has been shown to have high recurrence rates and several adjunct injectable therapeutic agents at the time of endoscopic treatment have been explored. Research supports amniotic membranes (AM) can be used clinically to promote apoptosis of pro-inflammatory cells, prevent differentiation of pro-fibrotic cells, and decrease scar formation. In the context of AM's anti-inflammatory and anti-fibrotic properties, this tissue has generated interest in reconstructive urethral surgery. Thus, we performed the first investigation of the success rate of urethral dilation when combined with micronized AM injection in urethral scar tissue for treatment of urethral stricture. METHODS: Eligible patients were adult males with anterior strictures ≤12Fr in diameter and≤2 cm in length, International Prostate Symptom Score (IPSS) ≥11 and maximum flowrate<15 ml/s. Reconstituted 100mg micronized AM was injected with a transurethral injection needle in the stricture region at the 5, 7 and 12 o'clock sites during urethral dilation. The primary study end point was anatomical success (≥14Fr by cystoscopy) at 6 months. Key secondary end points were evaluated with the IPSS, Urethral Stricture Surgery – Patient Related Outcome Measure (USS-PROM) and International Index of Erectile Function (IIEF) questionnaires, as well as measurements of flow rate and post void residual. Outcomes were assessed at baseline and at 5 days, 14 days, 3 months, and 6 months post-injection. The safety of injections was analyzed. RESULTS: Ten men with a mean age of 52±15 years were included. There were 7 patients with no prior endoscopic treatment of the urethral stricture and 3 patients with one prior dilation. At 6 months, 7 of 10 patients (70%) demonstrated recurrence of the urethral stricture on cystoscopy. Improvements in flow rate, PVR, IPSS and USS-PROM symptom scores were noted in 10 of 10 patients at 3 months and 3 of 10 patients at 6 months (Table 1). No adverse events observed. CONCLUSIONS: This is the first study evaluating single layer amnion as an adjunct treatment at time of urethral dilation. The urethral stricture rate of recurrence did not improve with the injection of AM despite the hypothesized benefits of anti-fibrotic and anti-inflammatory properties. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e518 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Nicholas Pryde More articles by this author Jack Vernocke More articles by this author Aron Liaw More articles by this author Michael Sessine More articles by this author Nivedita Dhar More articles by this author Expand All Advertisement PDF downloadLoading ...