Etiology of Posterior Urethral Strictures: Analysis of 116 Cases

Abstract

Purpose: In this study our aim was to investigate the current etiology of posterior urethral stricture disease in our department and to observe if there have been any differences in the major causes of urethral strictures. Patients and Methods: We analysed 116 male patients between March 2009 and September 2019 to evaluate the etiology of posterior urethral strictures. All patients had been assesed preoperatively,including detailed medical history,physical examination,retrograde urethrogram and uroflowmetry. We examined all patients in terms of age, stricture site,the most probable cause of the stricture and stricture length. We classified the location of posterior stricture into three anatomic parts: membranous urethra,prostatic urethra and bladder neck and stricture etiologies were subcategorized into idiopathic,inflammatory,iatrogenic and traumatic. Results: The most common site of the strictures was the membranous urethra (67 patients, 57.8%) followed by the prostatic urethra ( 27 patients, 23.3%) and bladder neck (22 patients, 18.9%). The two main overall posterior urethral stricture causes were iatrogenic (79 patients,68.1%) and traumatic (24 patients,20.7%).The less common causes were idiopathic (11 patients,9.5%) and urethritis(2 patients,1.7%). Of the patients in iatrogenic group, TUR-P and TUR-BT were the most common etiologic factors. ( 42 patients,36.2%) All urethral strictures were short(<2 cm) and treated with endourological surgery.( Optical İnternal Urethrotomy and urethral dilation) Conclusion: In our instution, especially iatrogenic causes were the most seen etiologic factor of posterior urethral strictures.These findings suggested us to be more careful during the endoscopic procedure , to use suitable calibered instrumentation and avoid unnecessary urethral interventions.