Re: The effects of hyaluronic acid and carboxymethylcellulose in preventing recurrence of urethral stricture after endoscopic internal urethrotomy: A multicenter, randomized controlled, single-blinded study

摘要

WE READ THE ARTICLE BY CHUNG AND COLLEAGUES with great interest. To treat urethral stricture, endo-scopic internal urethrotomy (EIU) is widely performed but associated with a high stricture recurrence rate. The authors of this study investigated the effects of intraurethral use of hyaluronic acid (HA) and carboxymethylcellulose (CMC) on the recurrence of urethral stricture after EIU. As the article showed, HA/CMC instillation significantly decreased the incidence of stricture recurrence, and the technique seems to be a potential breakthrough in the management of this old urologic problem. We would like to add our comments regarding this study, however, with the hope to improve future studies on this issue. First, as the authors stated, after instillation of HA/CMC, to block the bladder neck and keep HA/CMC between the urethral lumen and the Foley catheter, gauze was used to maintain the traction of the Foley catheter. The gauze was tied, and the Foley catheter was placed such that it faced upward and was fixed on the abdomen for 1 day. We believe this pressurized the catheter against the internal incision, which was performed at the 12 o'clock position. This could impact the efficacy of HA/CMC and epitheli-zation of the internal incision. Thus, the technique for maintaining the traction of the Foley catheter should be improved.