Clinical presentation and treatment of urethral stricture: Experience from a tertiary hospital in Port Harcourt, Nigeria

Abstract

IntroductionUrethral stricture disease (USD) is a common urological problem. The aetiology of strictures has been changing. Different treatment modalities are available. ObjectivesTo present the pattern and management of USD in Port Harcourt. Subjects and methodsThis was a retrospective study of all cases of USD treated in Port Harcourt Teaching Hospital between 2005 and 2015. All the case notes of patients treated for USD were retrieved. Data on demography, aetiology, site, treatment and outcome of treatment of USD were collated and analyzed using SPSS 20.0. ResultsWithin the period, 194 patients with urethral stricture were treated. There were 188 males (96.9%) and 6 females (3.1%). The mean age was 48±9.24 SD years. One hundred and forty four strictures (74.22%) were due to trauma. Of these, 37 (19.07%) were iatrogenic and 107 (55.15%) resulted from road traffic accidents, fall astride, etc. Forty eight (24.75%) and 2(1.03%) had post inflammatory and malignant urethral strictures respectively.Eighty two patients (42.27%) had anterior urethral stricture; while 78 (40.20%) had posterior urethral strictures. Twenty eight (14.43%) patients had long segment stricture involving both anterior and posterior segments. Twenty four and 71 patients had substitution and anastomotic urethroplasties respectively. One patient had penectomy for malignant stricture while 61 had endoscopic surgery. Twenty two percent had complications including: bleeding, wound infection and re-stricture. The stricture recurrence rate was 11.34%. ConclusionTrauma is the leading cause of USD in Port Harcourt. Iatrogenic strictures were common. Urethroplasty gives satisfactory outcome. Efforts should be made to reduce urethral injuries.