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A Retrospective Analysis of Urethral Strictures and Their Management at a Tertiary Care Center

AUTHORS

Rajkumar Mathur 1 , * , Dilip Nayak 2 , Gaurav Aggarwal 2 , Arvind Shukla 2 , Fareed Khan 2 , Sudarshan Odiya 2

1 Department of Surgery, MGM Medical College & M.Y.Hospital, rkmmyh60@yahoo.com, India

2 Department of Surgery, MGM Medical College & M.Y.Hospital, India

How to Cite: Mathur R, Nayak D, Aggarwal G, Shukla A, Khan F, et al. A Retrospective Analysis of Urethral Strictures and Their Management at a Tertiary Care Center, Nephro-Urol Mon. Online ahead of Print ; 3(2):109-113.

ARTICLE INFORMATION

Nephro-Urology Monthly: 3 (2); 109-113
Article Type: Research Article
Received: April 10, 2010
Accepted: May 10, 2010

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Abstract

Background: Surgical treatment of urethral strictures includes numerous options such as dilation, internal urethrotomy, stenting and reconstructive surgical techniques. Short uncomplicated strictures are generally amenable to complete excision with primary anastomosis. We performed a retrospective evaluation and analysis of outcome in patients who underwent any kind of treatment for urethral strictures.

Objectives: To evaluate and analyze the outcome in patients who underwent treatment for urethral stricture disease over the last 15 years (May 1993 to June 2008), at a tertiary care centre, as well as to determine the treatment option to be utilized in different varieties of urethral strictures.

Patients and Methods: We reviewed 524 patients who underwent treatment for urethral strictures between May 1993 and June 2008. Mean follow-up was 68 months. Preoperative evaluation included clinical history, physical examination, urine culture, residual urine estimation, uroflowmetry, and retrograde and voiding cystourethrography. Since 2000 urethral ultrasound was also performed in all patients. Clinical outcome was assessed by comparing pre and post operative investigation and patient satisfaction.

Results: Stricture etiology was catheter induced (15.36%), blunt perineal trauma (59.2%), instrumentation (12%), spontaneous (3.52%) and infection (10%). Stricture length was 0 to1cm (in 9.92%) 1 to 2 cm (in 32%), 2 to 3 cm (17.28%), 3 to 4 cm (24%) or 4 to 5 cm (8.8%) more than 5cm (16%). The success rates in these procedures were 93.6% (TAU-Tunica albuginea urethroplasty), 94.4% (USPBA-U shaped Prostato-bulbar Anastomosis), 91.7% (BMSU-Buccal Mucosa urethroplasty), 90% (IOU-Internal optic urethrotomy), 90.35% (dilatation) and 81% (two staged urethroplasty). There were 129 patients (25.49%) who experienced ejaculatory dysfunction. Good and fair results were considered successful. Of 524 cases 480 (91.6%) were successful and 44 (8.4%) were treatment failures.

Keywords

Urethra Urethral stricture Treatment outcome

© 0, Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.

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