Evidence map›Paper›PMID 37122691›Full record

ReviewEuropean urology open science2023

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.

Wesley Verla, Rachel Barratt, Garson Chan, Konstantinos Dimitropoulos, Francesco Esperto, Yuan Yuhong, Tamsin Greenwell, Nicolaas Lumen, Francisco Martins, Nadir Osman and 5 more

Abstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in European urology open science, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Wesley VerlaDept. of Urology, Ghent University Hospital, Ghent, Belgium.
Rachel BarrattDept. of Urology, University College London Hospital, London, UK.
Garson ChanDept. of Urology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
Konstantinos DimitropoulosDept. of Urology, Aberdeen Royal Infirmary, Aberdeen, Scotland, UK.
Francesco EspertoDept. of Urology, Campus Bio-Medico University, Rome, Italy.
Yuan YuhongDepartment of Medicine, Health Science Centre, McMaster University, Hamilton, ON, Canada.
Tamsin GreenwellDept. of Urology, University College London Hospital, London, UK.
Nicolaas LumenDept. of Urology, Ghent University Hospital, Ghent, Belgium.
Francisco MartinsDept. of Urology, Universidade de Lisboa, Hospital de Santa Maria, Lisbon, Portugal.
Nadir OsmanDept. of Urology, Royal Hallamshire Hospital, Sheffield, UK.
Achilles PloumidisDept. of Urology, Athens Medical Centre, Athens, Greece.
Silke RiechardtDept. of Urology, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany.
Marjan WaterloosDept. of Urology, Ghent University Hospital, Ghent, Belgium.
Felix Campos-JuanateyDept. of Urology, Hospital Universitario Marques de Valdecilla, Santander, Spain.
European Association of Urology Urethral Stricture Guidelines Panel

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

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 downregulation of collagen deposition and excessive scar tissue formation. Objective: To explore whether a course of ISD with topical corticosteroids is superior at stabilising urethral stricture disease in men and improving functional outcomes 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 successful 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 ( Conclusions: Based on the currently available data, a course of ISD with topical corticosteroids 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 intermittent self-dilatation after direct vision internal urethrotomy can better stabilise the stricture in the short term.

Indexed as

CorticosteroidsFunctional outcomesIntermittent self-dilatationMenUrethral stricture disease

Identifiers

PMID37122691
PMCPMC10130070

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.