Male Urethral Stricture Disease in a Regional Centre: 10 Years of Experience

Matthew K. H. Hong, Sita Murugappan, Sarah M. Norton, Eileen M. Moore, Richard Grills

Research output: Contribution to journalArticlepeer-review

Abstract

Background
Male urethral stricture disease is a challenging condition with a propensity for recurrence following endoscopic management. In recent years, earlier definitive urethral reconstruction has been advocated through international guidelines, prompted by series suggesting the underutilization of urethroplasty at rates of 0.6–0.8%. However, little local data exists to characterize our urethral stricture patients and we aimed to characterize the management of patients with urethral stricture disease presenting over a 10-year period to a single regional centre.

Methods
Patients with urethral stricture disease and admitted to a regional health service were identified. Retrospective chart review was undertaken for patients detailing basic demographics, stricture characteristics, clinical management and follow up.

Results
We identified 360 patients with median age 69 years (interquartile range 56–77). A total of 191 (53%) presented with lower urinary tract symptoms, 122 (34%) urethral strictures were incidental, and 13% presented in urinary retention. Bulbar urethral strictures were the commonest strictures at 40% with most being spontaneous or idiopathic (67%). A total of 339 patients had treatment during their first admission, 48% of patients had subsequent treatment on a second episode, and over 20% had a third or subsequent treatment. Only 21 (5.8%) underwent urethroplasty. Urethral dilatation and optical urethrotomy were most commonly performed (54%). With follow up 19 months (interquartile range 2–56), 205 (57%) were voiding, 38 (11%) were performing intermittent catheterization, and 59 were catheterized permanently.

Conclusion
Definitive urethral reconstruction appears underutilized in our cohort of patients. A high proportion of incidentally presenting urethral strictures emphasizes the importance of wider education to optimize patient outcomes.
Original languageEnglish
Pages (from-to)747-751
Number of pages5
JournalANZ Journal of Surgery
Volume89
Issue number6
Early online date13 May 2019
DOIs
Publication statusPublished - Jun 2019
Externally publishedYes

Keywords

  • Male urethral stricture disease
  • Catheters
  • Urethral reconstruction

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