@article{01H3YCMG1PC15PWG1K5GVEYMPH,
  abstract     = {{Context: Intermittent self-dilatation (ISD) is a therapeutic strategy used to stabilise a urethral stricture and postpone or avoid further treatment. Adding corticosteroids to this mode of management might further enhance its outcomes by downregula-tion of collagen deposition and excessive scar tissue formation.Objective: To explore whether a course of ISD with topical corticosteroids is supe-rior at stabilising urethral stricture disease in men and improving functional out-comes over a course of ISD alone. Evidence acquisition: This systematic review and meta-analysis was undertaken by the European Association of Urology Urethral Strictures Guideline Panel according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines (CRD42021256744). The primary benefit outcome was suc-cessful stabilisation of the urethral stricture. Treatment-related complications were the primary harm outcome.Evidence synthesis: In total, 978 records were screened for eligibility, ultimately leading to five included studies, all randomised controlled trials, comprising 250 patients, of whom 124 underwent a course of ISD with corticosteroids and 126 underwent a course of ISD alone, all after direct vision internal urethrotomy (DVIU). Successful stabilisation of the stricture was achieved in 77% and 64% of patients in the group with and without corticosteroids, respectively (p = 0.04). No extra complications related to the addition of corticosteroids to the ISD regimen were reported. The risk of bias of the included studies was generally unclear to high.Conclusions: Based on the currently available data, a course of ISD with topical cor-ticosteroids appears to be safe and superior at stabilising a urethral stricture after DVIU in the short term to a course of ISD alone. However, given the unclear to high risk of bias in the included studies, further high-quality studies are needed to fully underpin this.Patient summary: This study shows that addition of topical corticosteroids to inter-mittent self-dilatation after direct vision internal urethrotomy can better stabilise the stricture in the short term.(c) 2023 The Authors. Published by Elsevier B.V. on behalf of European Association of Urology. This is an open access article under the CC BY-NC-ND license (http://creative-commons.org/licenses/by-nc-nd/4.0/).}},
  author       = {{Verla, Wesley and  Barratt, Rachel and  Chan, Garson and  Dimitropoulos, Konstantinos and  Esperto, Francesco and  Yuhong Yuan, [missing] and  Greenwell, Tamsin and Lumen, Nicolaas and  Martins, Francisco and  Osman, Nadir and  Ploumidis, Achilles and  Riechardt, Silke and Waterloos, Marjan and  Campos-Juanatey, Felix}},
  issn         = {{2666-1691}},
  journal      = {{EUROPEAN UROLOGY OPEN SCIENCE}},
  keywords     = {{Men,Functional outcomes,Urethral stricture disease,Corticosteroids,Intermittent self-dilatation}},
  language     = {{eng}},
  pages        = {{95--105}},
  title        = {{Is a course of intermittent self-dilatation with topical corticosteroids superior at stabilising urethral stricture disease in men and improving functional outcomes over a course of intermittent self-dilatation alone? A systematic review and meta-analysis}},
  url          = {{http://doi.org/10.1016/j.euros.2023.01.011}},
  volume       = {{51}},
  year         = {{2023}},
}

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