Efficacy of steroid use in the prevention of urethral stricture following transurethral resection of prostate: a review of the literature

Background: Urethral stricture is a frequent complication following transurethral resection of the prostate (TURP), primarily due to excessive collagen synthesis and fibrosis.Initial management includes minimally invasive procedures such as urethrotomy and urethral dilation, which, however, have high recurrence rates.Adjunctive therapies involving local injection or topical drug administration have been explored to reduce these recurrences.Objective: The objective of this study was to systematically review the efficacy of topical and injectable steroids in preventing urethral stricture after TURP.Methods: A comprehensive literature search was conducted in the National Library of Medicine for studies published between 2017 and 2025.Twenty-four studies investigating agents such as triamcinolone, 5-fluorouracil combinations, and Mitomycin C (MMC) were included.Results: Treatment with these agents was associated with a significant reduction in urethral stricture recurrence compared to controls receiving no additional therapy.MMC demonstrated the highest efficacy.In addition, paclitaxel-coated balloons, delivering an antiproliferative agent through combined mechanical dilation and localized administration, showed promising short-term safety and efficacy profiles.Conclusion: Topical and injectable therapies effectively reduce urethral stricture recurrence after TURP, with MMC and paclitaxel being the most notable agents.Further long-term studies are warranted to confirm these findings.