The efficacy and safety of mitomycin C intra urethral injection to prevent recurrent urethral stricture: A systematic review and meta-analysis

Firmantya Hadi Pranata; Furqan Hidayatullah; Yudhistira Pradnyan Kloping; Zakaria Aulia Rahman; Fikri Rizaldi; Doddy Moesbadianto Soebadi

doi:10.1016/j.amsu.2022.103576

The efficacy and safety of mitomycin C intra urethral injection to prevent recurrent urethral stricture: A systematic review and meta-analysis

Ann Med Surg (Lond). 2022 Apr 4:77:103576. doi: 10.1016/j.amsu.2022.103576. eCollection 2022 May.

Authors

Firmantya Hadi Pranata¹, Furqan Hidayatullah¹, Yudhistira Pradnyan Kloping¹, Zakaria Aulia Rahman¹, Fikri Rizaldi², Doddy Moesbadianto Soebadi¹

Affiliations

¹ Department of Urology, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo General-Academic Hospital, Indonesia.
² Department of Urology, Faculty of Medicine, Universitas Airlangga, Universitas Airlangga Teaching Hospital, Indonesia.

Abstract

Objectives: Direct Vision Internal Urethrotomy (DVIU) is regarded as the most popular and frequently used minimal invasive approach for treating urethral stricture. However, the application of this procedure is limited due to the high recurrence rate. Recent trials have the benefit of mitomycin C as adjuvant therapy to reduce the stricture recurrence in DVIU procedures. In this meta-analysis, we aim to determine the efficacy of mitomycin C as adjuvant therapy for DVIU.

Methods: A systematic literature search was carried out from Embase, ScienceDirect, and PubMed published up to September 2021. Relevant Randomized Controlled Trials (RCTs) were screened using our eligibility criteria. The quality assessment of the RCT was assessed using Cochrane RoB 2. The outcome was measured as an Odds Ratio (OR) with 95% Confidence Intervals (CIs). Statistical analyses were performed using RevMan 5.4.

Results: We included four RCTs in the meta-analysis, with a total of 392 patients with urethral strictures undergoing DVIU. The pooled analysis showed a significantly lower recurrence rate in patients undergoing DVIU with additional treatment of mitomycin C compared to the control group (OR 0.27, 95% CI 0.16-0.45, p < 0.0001).

Conclusion: Our findings highlight the benefit of adjuvant treatment with mitomycin C to reduce the incidence of urethral stricture recurrence after DVIU procedures.

Keywords: Direct vision internal urethrotomy; Mitomycin C; Stricture recurrence; Urethral stricture.

Publication types

Review