triamcinolone in urethral strictures

Urethral stenosis is, after the fistula, the most frequent complication in patients undergoing hypospadias repair. Incidence ranges between 6% and 10% depending on the surgical technique. Treatment of this complication with simple dilation of the narrowed segment is enough in most cases. However, dilation of the stricture may be difficult in patients with severe hypospadias that required wide dissection and excision of fibrotic tissue to repair a large deviation and also in patients who had previously multiple operations...

Three cases of urethral stricture due to balanitis xerotica obliterans (BXO) after hypospadias repair are reported. The first patient showed white, dense scarring on the prepuce before the hypospadias repair and developed a stricture of the urethra after the operation. The second and the third were uneventful for 6 and 2 years, respectively, after the hypospadias repair, and then developed urethral strictures. Pathologic diagnosis of the stenotic lesion is essential. Complete excision of the affected urethra with topical steroid ointment or sublesional triamcinolone injection is recommended for this condition...

We report 2 cases of Cushing's syndrome following intralesional triamcinolone acetonide injections of urethral strictures in children. The pharmacology of triamcinolone and its 2 parenteral forms, triamcinolone acetonide and triamcinolone diacetate, is discussed. For children we recommend the short-acting triamcinolone diacetate at 4-week intervals with dosage adjusted to age. In adults either type of triamcinolone may be used but triamcinolone acetonide should be given at 6-week intervals.

The management of urethral strictures in children prior to urethroplasty has involved dilation and internal urethrotomy. Low success rates with these modalities led to the evaluation of visual urethrotomy and intralesional steroid injection. Of 12 patients so managed 10 achieved an excellent result, with 2 classified as having good results initially. These 2 cases were ultimately converted into the excellent category following repeat procedures. Non-invasive urinary flow rates proved invaluable in the management and assessment of these patients, and the success of their treatment...

Optical internal urethrotomy is a safe operative procedure for the management of a prevailing number of strictures of the male urethra. During the years 1976--1978, urethrotomy was carried out in 149 patients and the results are evaluated 1--3 years postoperatively. In the series of patients treated by urethrotomy without corticoid injection the rate of recurrent stricture was 19.4%. Using a specially constructed needle for injection of triamcinolone acetonide (Kenalog), we were able to reduce the recurrence rate to 4...

No abstract text is available yet for this article.

A review of steroid management of urethral strictures is presented. The 96 patients were followed for a year or more after urethral injection with triamcinolone. Intralesional steroid may be used in many types of strictures but it is especially useful in those cases with strictures in the distal urethra or the meatus, those occurring after radical prostatectomy and in some cases when 1 or more urethroplasties have been done. Every practicing urologist can benefit from using stricture injection in selected cases...

The advent of selective internal urethrotomy under direct vision has enabled precision endoscopic surgery to be undertaken on a wide range of urethral strictures. A multi-centre survey of 197 cases involving 322 urethrotomy procedures from 5 urological departments in England is reported. The overall results after a follow-up of up to 4 years suggest that there is no indication for further procedures currently existing in 160 (81%) of those cases subjected to selective internal urethrotomy. The additional injection of triamcinalone acetate into the strictured area prior to urethrotomy is recommended in resistant cases...