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LishitonglinUS-01 Trial

NCT07769060 — Phase 2, Active not recruiting, 120 participants, Peking University First Hospital

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Efficacy and Safety Evaluation of Lishitonglin Formula in Improving Preoperative Non-Severe Urinary Tract Infections and Lower Urinary Tract Symptoms in Patients With Urethral Stricture

RegistryNCT07769060
StatusActive not recruiting
PhasePhase 2
Study typeInterventional; randomized, parallel, masking: double, treatment
Enrollment120 (Estimated)
SponsorPeking University First Hospital (Other)
ConditionsUrethra Stricture
InterventionsLishitonglin Formula granules, Oral placebo medication formulated as granules (Drug)
Datesstart 2026-01-09, primary completion 2027-08-31 (estimated), completion 2028-08-31 (estimated), first posted 2026-08-17, last updated 2026-08-17
Locations1 site in China

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-Summary

This study intends to conduct a prospective, randomized, double-blind, placebo-controlled trial to investigate the efficacy and safety of Lishi Tonglin Granule (a hospital-formulated innovative prescription) developed in our hospital for alleviating preoperative urinary tract infections in patients with urethral stricture, and to further explore its effects on preoperative lower urinary tract irritation symptoms as well as short- and medium-term postoperative stricture recurrence rates.

This protocol is jointly implemented by the Department of Urology and the Department of Integrated Traditional Chinese and Western Medicine. Adopting the TCM therapeutic concept of "clearing the source and unblocking collaterals" combined with Western surgical intervention, the trial compares the primary outcome measures between the intervention group (administered Lishi Tonglin Prescription) and the control group (administered placebo), including preoperative bacteriuria clearance rate, lower urinary tract symptom scores and TCM syndrome scores, to identify significant intergroup differences.

Comprehensive analyses will also be performed on postoperative short- and medium-term urination improvement, urethral stricture recurrence risk, distribution of uropathogens and antimicrobial susceptibility profiles of the two groups. This research features innovations in integrated Chinese-Western diagnostic and therapeutic theories, prescription optimization, and a multi-dimensional evaluation framework. Its findings can validate the clinical potential of Lishi Tonglin Prescription as an alternative to antibiotics, and lay a theoretical foundation for future mechanistic research and clinical translation of integrated Chinese-Western therapy for urinary tract infections secondary to lower urinary tract obstruction.

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+Detailed description

This study intends to conduct a prospective, randomized, double-blind, placebo-controlled trial to investigate the efficacy and safety of Lishi Tonglin Granule (a hospital-formulated innovative prescription) developed in our hospital for alleviating preoperative urinary tract infections in patients with urethral stricture, and to further explore its effects on preoperative lower urinary tract irritation symptoms as well as short- and medium-term postoperative stricture recurrence rates.

This protocol is jointly implemented by the Department of Urology and the Department of Integrated Traditional Chinese and Western Medicine. Adopting the TCM therapeutic concept of "clearing the source and unblocking collaterals" combined with Western surgical intervention, the trial compares the primary outcome measures between the intervention group (administered Lishi Tonglin Prescription) and the control group (administered placebo), including preoperative bacteriuria clearance rate, lower urinary tract symptom scores and TCM syndrome scores, to identify significant intergroup differences.

Comprehensive analyses will also be performed on postoperative short- and medium-term urination improvement, urethral stricture recurrence risk, distribution of uropathogens and antimicrobial susceptibility profiles of the two groups. This research features innovations in integrated Chinese-Western diagnostic and therapeutic theories, prescription optimization, and a multi-dimensional evaluation framework. Its findings can validate the clinical potential of Lishi Tonglin Prescription as an alternative to antibiotics, and lay a theoretical foundation for future mechanistic research and clinical translation of integrated Chinese-Western therapy for urinary tract infections secondary to lower urinary tract obstruction.

+Arms and interventions

ArmTypeInterventionsDescription
Trial Group - Mild Stenosis GroupExperimentalDrug: Lishitonglin Formula granulesBegin taking the oral Lishitonglin Formula granules one week prior to surgery (one dose twice daily, dissolved in warm water).
Trial Group - Moderate to Severe Stenosis GroupExperimentalDrug: Lishitonglin Formula granulesBegin taking the oral Lishitonglin Formula granules one week prior to surgery (one dose twice daily, dissolved in warm water).
Control Group - Mild Stenosis GroupPlacebo comparatorDrug: Oral placebo medication formulated as granulesOne week prior to surgery, patients began receiving oral placebo medication formulated as granules containing 10% of the active ingredients and matching the appearance of the LIshitonglin formula (1 dose twice daily, dissolved in warm water).
Control Group - Moderate to Severe Stenosis GroupPlacebo comparatorDrug: Oral placebo medication formulated as granulesOne week prior to surgery, patients began receiving oral placebo medication formulated as granules containing 10% of the active ingredients and matching the appearance of the LIshitonglin formula (1 dose twice daily, dissolved in warm water).
  • Lishitonglin Formula granules (Drug): Begin taking the oral Lishitonglin Formula granules one week prior to surgery (one dose twice daily, dissolved in warm water).
  • Oral placebo medication formulated as granules (Drug): One week prior to surgery, patients began receiving oral placebo medication formulated as granules containing 10% of the active ingredients and matching the appearance of the LIshitonglin formula (1 dose twice daily, dissolved in warm water).

+Outcome measures

Primary outcomes

  • Bacterial clearance rate [Before taking the drug and one day before operation]: After 7 days of treatment, the rate of reduction in urinary leukocyte count under high-power microscopy compared to pre-treatment levels, urinary leukocyte count (high-power microscopy), and urinary culture conversion rate

Secondary outcomes

  • Urine White Blood Cell Count on the First Day After Surgery [Postoperative Day 1]: Urine White Blood Cell Count Under High-Power Microscope in a Routine Urinalysis (Unit: cells/HP)
  • Traditional Chinese Medicine Syndrome Scoring [Before taking the drug and one day before operation]: Urinating stenosis, frequent urination, urgency, and painful urination (4 items; scored on a 0-3 scale, with each item scored separately; 0 being the mildest and 3 the most severe)
  • Recurrence rate [Postoperative 3 months & 1 year]: US Recurrence rate, followed by Urethrography, uroflowmetry, urethroscopy, and IPSS score
  • Drug related adverse effects [Through study completion, on average of 1 week]: Drug related adverse effects detected by real-time observation, inquiry, and recording
  • Urine Culture Positivity Rates and Microorganism Types [Before taking the drug and one day before operation]: This refers to the proportion of patients with positive preoperative urine cultures, and includes documentation of the microbial species and antibiotic resistance profiles of the positive cultures.
  • International Prostate Symptom Score (IPSS) [Before taking the drug and one day before operation]: This scale includes seven symptoms: frequent urination, urinary urgency, nocturia, incomplete emptying, interrupted urination, difficulty urinating, and a weak urine stream. Each symptom is scored on a scale of 0-5 based on frequency and severity. The total score is categorized as follows: (0-7) mild, (8-19) moderate, and (20-35) severe.

+Eligibility

Sex: Male, ages: 18 Years to 80 Years

Inclusion Criteria:

* 1\. Adult male patients (≥18 years old) with urethral stricture diagnosed by urethrography and presenting urinary obstruction symptoms (AUA grade II-III) with or without preoperative bladder diversion via ostomy.
* 2\. No concurrent severe urinary tract infection (meeting both criteria): · Urinary tract irritation symptoms (frequency, urgency, dysuria)
* 3\. Urinary leukocytes ≥10 (HPF)
* 4\. Midstream urine culture colony count ≥10⁵ CFU/mL
* 5\. Traditional Chinese Medicine pattern identification: damp-heat descending syndrome (primary symptoms: frequent, urgent, painful urination, red tongue with thick yellow coating)
* 6\. Planned intraurethral procedures (including urethrotomy/urethral dilation/urethral balloon dilation) or open urethroplasty (including end-to-end urethral stricture resection/autologous mucosal patch urethroplasty).

Exclusion Criteria:

* 1\. Patients with severe infection presenting clinically significant symptoms at enrollment: e.g., those with fever, active hematuria, pyuria, urethral condyloma, or septic shock
* 2\. Urinary tract infections complicated by complex urinary tract anomalies (e.g., congenital hypospadias, fistula) or uncontrolled malignant tumors such as urethral cancer or bladder cancer
* 3\. Severe hepatic or renal dysfunction (ALT/AST > 2× upper limit of normal, Scr > 133 μmol/L)
* 4\. Concurrent immunodeficiency disorders or use of immunosuppressive agents
* 5\. Allergy to any component of the study drug
* 6\. Individuals refusing to participate in this study.

+Locations (1)

FacilityCityCountryStatus
Peking University First HospitalBeijing, Beijing MunicipalityChina

+Publications

  • Kim S, Cheng KC, Alsikafi NF, Breyer BN, Broghammer JA, Elliott SP, Erickson BA, Myers JB, Smith TG 3rd, Vanni AJ, Voelzke BB, Zhao LC, Buckley JC. Minimizing Antibiotic Use in Urethral Reconstruction. J Urol. 2022 Jul;208(1):128-134. doi: 10.1097/JU.0000000000002487. Epub 2022 Feb 25. PMID 35212569
  • Heyns CF. Urinary tract infection associated with conditions causing urinary tract obstruction and stasis, excluding urolithiasis and neuropathic bladder. World J Urol. 2012 Feb;30(1):77-83. doi: 10.1007/s00345-011-0725-9. Epub 2011 Jul 1. PMID 21720861
  • Shaw NM, Venkatesan K. Endoscopic Management of Urethral Stricture: Review and Practice Algorithm for Management of Male Urethral Stricture Disease. Curr Urol Rep. 2018 Feb 26;19(3):19. doi: 10.1007/s11934-018-0771-6. PMID 29479640
  • Hampson LA, McAninch JW, Breyer BN. Male urethral strictures and their management. Nat Rev Urol. 2014 Jan;11(1):43-50. doi: 10.1038/nrurol.2013.275. Epub 2013 Dec 17. PMID 24346008
  • Campos-Juanatey F, Osman NI, Greenwell T, Martins FE, Riechardt S, Waterloos M, Barratt R, Chan G, Esperto F, Ploumidis A, Verla W, Dimitropoulos K, Lumen N. European Association of Urology Guidelines on Urethral Stricture Disease (Part 2): Diagnosis, Perioperative Management, and Follow-up in Males. Eur Urol. 2021 Aug;80(2):201-212. doi: 10.1016/j.eururo.2021.05.032. Epub 2021 Jun 5. PMID 34103180
  • Payne SR, Anderson P, Spasojevic N, Demilow TL, Teferi G, Dickerson D. Male urethral stricture disease: why management guidelines are challenging in low-income countries. BJU Int. 2022 Aug;130(2):157-165. doi: 10.1111/bju.15831. Epub 2022 Jul 7. PMID 35726391

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