The Effect of Botulinum Toxin (Masport) Injection following Internal Urethrotomy of Bulbar Urethral Stricture: A Pilot Study

Abstract Background The application of Botulinum toxin (Masport) in urology has a long history. We aimed to assess the effect of local Masport on improvement in patients with urethral stricture by reducing the recurrence of urethral stricture. Methods This pilot study conducted was a double-blind randomized clinical trial on patients suffering from urethral stricture. Finally, 28 patients were allocated to intervention and control groups. Twelve patients received intralesional injection with Masport in addition to internal urethrotomy, while sixteen patients only underwent internal urethrotomy. The Cox regression hazard model was used to evaluate the effect of treatment status on recurrence time adjusted for the age, length, and location of the stenosis, cause of the stenosis, and history of previous operations. Results The effect of treatment type was significant, at the 0.05 level. The past medical history and cause of urethral stricture had a significant impact on relapse-free survival. Also, the improvement in the mean scores of the EuroQol Visual Analogue Scale (EQ-VAS), International Prostate Symptom Score (IPSS), and Q-max in the group with Masport was significantly different from the group without Masport. Conclusion The internal urethrotomy as well as intralesional injection of Masport has a better survival prognosis than the only underwent internal urethrotomy group. The use of Masport injection during internal urethrotomy shows improvement in the quality of life of patients and reduces the recurrence of stenosis. Therefore, it is suggested as a treatment adjunctive option for urethral stricture.