Abstract
Background: Male urethral stricture is a disease with a high incidence rate. With social-economic development in the developing countries, the trend of etiology and treatment of male urethral stricture changed was speculated.Methods: The clinical data of the male patients with urethral stricture from 2000 to 2019 were analyzed. The subjects were divided into Group A (2000–2009) and Group B (2010–2019) according to treatment time. The pooled analysis of the data extracted from pieces of literature was also performed.Results: About 540 patients were included in the present study, including 235 patients in Group A and 305 patients in Group B. In recent 10 years, trauma has still been the main cause of urethral stricture. Iatrogenic injury, especially transurethral operation, increases significantly, while male urethral stricture secondary to radiotherapy and infection decrease. Urethroplasty increases and the reoperation rate decreases in treating simple urethral stricture, and flap urethroplasty also increases in treating complex urethral stricture. The results of a pooled analysis of data from 11 centers in Mainland China are partially consistent with it. Complications, such as urethral fistula, false canal, ejaculation disorder, and penile curvature, decrease significantly.Conclusions: The main causes of urethral stricture in the recent 10 years are still trauma and iatrogenic injuries, and the etiology of urethral stricture is related to socioeconomic development. With the increase of intracavitary minimally invasive treatment and flap urethroplasty, the curative effect is increasing, while iatrogenic urethral stricture cannot be ignored.
Highlights
Male urethral stricture (MUS) is a common disease and manifested by dysuria, which is often accompanied by urinary tract infection, and even damages renal function, causes male sexual dysfunction, and lowers the quality of life of patients [1]
Inclusion criteria were as follows: [1] ≥18 years old; [2] patients with a history of MUS; [3] patients with symptomatic MUS diagnosed by urethroscopy and urethrography; [4] patients who received treatment related to MUS, but failed to recover; [5] patients with external urethral orifice stricture, and diagnosed with lichen sclerosus
Exclusion criteria were as follows: [1] patients with MUS caused by malignant tumors; [2] patients with untreated hypospadias; [3] patients diagnosed with MUS, accompanied by acute urinary tract infection for the first time, and only received suprapubic cystostomy and anti-infective therapy
Summary
Male urethral stricture (MUS) is a common disease and manifested by dysuria, which is often accompanied by urinary tract infection, and even damages renal function, causes male sexual dysfunction, and lowers the quality of life of patients [1]. As a populous country with developed infrastructures and coal industry, China has suffered a lot from MUS-related social burden, while Hunan Province is a miniature of this situation to some extent. There is no national epidemiology investigation of MUS at present [3]; it is necessary to analyze the trend of MUS in various regions of China. The clinical data of patients with MUS were collected in the present study, and the trends of etiology, treatment methods, and outcomes of them were analyzed in the past 20 years, aiming to fill pieces of literature in this field. With socialeconomic development in the developing countries, the trend of etiology and treatment of male urethral stricture changed was speculated
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