Modified platelet-rich plasma with transforming growth factor β1 neutralization antibody injection may reduce recurrence rate of urethral stricture.

Urethral stricture is one of the most bothersome urologic disease among urologists and has a substantial impact on quality of life and healthcare costs. Although it can be cured with internal urethrotomy easily, post-surgery stricture recurrence is challenging. Several adjuvant therapies have been used in conjunction with internal urethrotomy but none of them are used routinely because the pathophysiology of the disease is still obscure. Fibrosis is the most accused hypothesis for the action. Platelet-rich plasma (PRP) is an autologous blood product containing a high concentration of platelets that is being used for a very wide range of clinical healing applications. It comprises a concentration of fundamental protein growth factors shown to be actively excreted by platelets to initiate accurate wound healing. Although PRP can play a critical role in wound healing and has been used in fibrotic diseases successfully, it has some deleterious cytokines such as transforming growth factor β1 (TGF β1) which can also cause fibrosis. The new hypothesis is that the subcutaneous injection of neutralized platelet-rich plasma with TGFβ1 antibody at the planned urethrotomy site may prevent recurrence and provide superior healing and long-term results.