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| Name | Class |
|---|---|
| Instituto de Investigación Biosanitaria de Granada (ibs.Granada) | UNKNOWN |
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There is currently no prognostic or predictive risk marker for this urethral stricture disease.
The most conservative standard treatment for urethral stricture (internal urethrotomy) has a very high recurrence rate (greater than 75%) and, on many occasions, reconstructive urologists have to choose within a great variety of further complex interventions. Knowing risk and predictive markers of this disease could help to optimize both the need and the approach for these surgeries and may offer a more individualized management to patients.
The pathophysiological mechanisms that influence the development of urethral stricture are not established. In developed countries, the most common etiology of urethral stricture is idiopathic (41%) followed by iatrogenic (35%).
Serum testosterone is important in urethral development, in the integrity of the corpora cavernosa and has been shown to play a fundamental role in the development of genital structures. Recently, hypoandrogenism (HA) has been associated with a decrease in urethral androgen receptors and periurethral vascularization. Furthermore, low serum testosterone levels appear to be implicated in an increased risk of urethral atrophy.
In recent years it has been proven that coagulation, in addition to influencing the formation of the provisional matrix, participates in mechanisms of tissue injury through the activation of PARs. As a result, the coagulation cascade directly influences several key aspects of the wound healing response, from platelet aggregation and vasoconstriction, but also inflammation and scar formation. Although it is strictly regulated under normal conditions, an imbalance in favor of a procoagulant state as occurs in many pathologies of other organs (liver, lung, kidney) has the potential to deregulate inflammatory and tissue repair mechanisms and culminate in fibrosis.
In general, it is accepted that the probability of developing a urethral stricture after endoscopic treatment is around 2-10% of cases. However, this complication has never been studied in depth and the true incidence of urethral stricture, and its consequences in quality of life, after a transurethral procedure is unknown.
The aim of this study is to analyze the potential role of serum hormonal status and coagulation disorders as risk factors for the development of urethral stricture after transurethral surgery.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Cases. Patients who develop urethral stricture | Patients who develop urethral stricture within 6 months after TUR P/B |
| |
| Controls. Patients who DO NOT develop urethral stricture | Patients who DO NOT develop urethral stricture within 6 months after TUR P/B |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Transurethral resection of the prostate or bladder | Procedure | All patients undergoing TUR P/B will undergo a blood draw within 6 months after surgery to determine hormonal status and coagulation disorders. |
| Measure | Description | Time Frame |
|---|---|---|
| Development of anatomic urethral stricture | It will be studied in all patients by flexible urethroscopy | 6 months |
| Measure | Description | Time Frame |
|---|---|---|
| Development of functional urethral stricture | Studied by uroflowmetry and PROM questionnaries | 6 months |
| Measure | Description | Time Frame |
|---|---|---|
| Hormonal status | Determination of serum sexual hormones (Testosterone, estrogens, FSH, LH), TSH, T4 and PRL | Within 6 months after TUR P/B |
| Coagulation disorders | Comprehensive profile of procoagulation disorders determined in peripheral blood |
Inclusion Criteria:
Exclusion Criteria:
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Patients undergoing transurethral resection of the prostate or bladder
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Ignacio Puche Sanz, MD PhD | Contact | 0034 958 020 145 | ignacio.puche.sspa@juuntadeandalucia.es |
| Name | Affiliation | Role |
|---|---|---|
| Ignacio Puche-Sanz, MD PhD | University Hospital Virgen de las Nieves | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Hospital Universitario Virgen de las Nieves | Recruiting | Granada | 18003 | Spain |
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| The day before TUR P/B |
| ID | Term |
|---|---|
| D014525 | Urethral Stricture |
| D005355 | Fibrosis |
| ID | Term |
|---|---|
| D014524 | Urethral Obstruction |
| D014522 | Urethral Diseases |
| D014570 | Urologic Diseases |
| D052776 | Female Urogenital Diseases |
| D005261 | Female Urogenital Diseases and Pregnancy Complications |
| D000091642 | Urogenital Diseases |
| D052801 | Male Urogenital Diseases |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| ID | Term |
|---|---|
| D020728 | Transurethral Resection of Prostate |
| ID | Term |
|---|---|
| D011468 | Prostatectomy |
| D013521 | Urologic Surgical Procedures, Male |
| D013520 | Urologic Surgical Procedures |
| D013519 | Urogenital Surgical Procedures |
| D013514 | Surgical Procedures, Operative |
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