Use of autologous platelet-rich plasma in short-segment urethral stricture (a comparative study): Experience in a tertiary care hospital.

BACKGROUND

Optical internal urethrotomy (OIU) remains a common intervention for short-segment urethral stricture, but recurrence rates remain high. Platelet-rich plasma (PRP), rich in bioactive growth factors, may enhance wound healing and reduce fibrosis. This study evaluates the impact of submucosal autologous PRP injection as an adjunct to OIU.

METHODOLOGY: In this prospective comparative study, 64 patients with short-segment urethral stricture (<2 cm) were randomized into two equal groups: OIU alone (control) and OIU with submucosal PRP injection (PRP group). Four milliliters of autologous PRP were injected at eight submucosal sites after urethrotomy. Primary outcome was postoperative maximum flow rate (ml/min) (Qmax) at 6 months. Nonparametric statistics (Mann-Whitney U-test) were used.

RESULTS

Baseline demographics and preoperative flow parameters were comparable between groups (P > 0.05). At 6 months, mean Qmax improved from 6.39 to 17.34 mL/s in the PRP group and from 5.93 to 11.39 mL/s in the control group (P < 0.001). Median Qmax was 17 vs. 12 mL/s, respectively. Mann-Whitney analysis demonstrated a significant difference (U = 123, P < 0.001; effect size r ≈ 0.53). No major complications were observed.

CONCLUSION

Submucosal PRP injection significantly enhances postoperative urinary flow following OIU. Its regenerative and antifibrotic properties suggest a promising role as an adjunct therapy. Larger trials with long-term follow-up are needed to determine durability of benefit and recurrence outcomes.