Effects of Hyaluronic Acid and Carboxymethylcellulose on Urethral Stricture After Transurethral Resections of the Prostate for Benign Prostatic Hyperplasia: A Multicenter, Single Blinded, Randomized Controlled Study

Abstract

Purpose: To evaluate the effect of hyaluronic acid (HA) and carboxymethylcellulose (CMC) instillation after transurethral resection of the prostate (TURP) on preventing urethral stricture.Patients and Methods: A total of 180 patients underwent TURP for benign prostatic hyperplasia. Recruited patients were randomly divided into two groups: Groups A and B. Patients in group A (90 patients, experimental group) received HA/CMC instillation, and patients in the group B (90 patients, control group) received lubricant instillation after TURP. Each patient was evaluated at 4 weeks (V1), 12 weeks (V2), and 24 weeks (V3) after the surgery. The effectiveness of HA/CMC instillation was evaluated based on the International Prostate Symptom Score/Quality of Life, peak urine flow rate, voided volume, and postvoid residual volume. The visual analogue scale (VAS) pain score and degree of satisfaction were also determined for each participant.Results: Among 180 initial participants, 80 patients in group A and 81 patients in group B had completed the experiment. VAS pain scores were 0.75 +/- 0.75 and 1.75 +/- 1.37 (P < 0.001), and degrees of satisfaction were 0.63 +/- 0.66 and 0.91 +/- 0.51 in group A and group B at 1 month after surgery (P = 0.002). By retrograde urethrography, urethral stricture after TURP was seen in 1 of 80 subjects in group A and 7 of 81 subjects in group B.Conclusions: HA/CMC instillation after TURP decreased the incidence of urethral stricture. In addition, HA/CMC was effective at reducing pain during the early postoperative period, with no adverse effects.