A 10-year review of urethral stricture management in Irrua, Nigeria

Abstract

Background:Several authors have demonstrated regional and temporal changes in the demographics of urethral stricture and its management.Objectives:To assess the changes in the demographics of the patients and the evolution of the management of urethral stricture in this institution.Subjects and Methods:This is a retrospective study. The files of all the men who were diagnosed with urethral stricture from May 2006 to April 2016 were retrieved from the database of the records department of the hospital. The predictor variables assessed included age at presentation, occupation, etiology, presenting symptoms, stricture site, length of stricture, treatment method, year of treatment, complications of treatment, result of urine microscopy and sensitivity, comorbidities, and social habits of the patients. The outcome variables were the proportion of men in relation to the predictor variables and the test of correlation (P = 0.05 and below significant). Analysis was done using the Statistical Package for the Social Sciences (SPSS) version 21.Results:Forty-six patients were diagnosed as having urethral stricture within the study period. All were males. The mean age was 53.11 years (standard deviation 17.63852) with a range from 19 to 96. There were 4 (8.7%) students, 11 (23.9%) civil servants, 4 (8.7%) businessmen, 3 (6.5%) military men, and 24 (52.2%) others who were essentially artisans. Majority of them (68.9%) presented with lower urinary tract symptoms while Escherichia coli was the most commonly cultured organism from their urine (17.4%). The most common single etiology was urethritis (30.4%). From 2013 onward, there was an abrupt transition from conservative treatment using dilatation which dropped from 38.9% to 17.9%. More complex surgeries such as buccal mucosal graft urethroplasty for bulbar strictures and two-stage repair for penile strictures increased from 11.1% to 57.1%.Conclusion:Urethritis is still the most common single etiological factor in urethral stricture disease in this rural community. Artisans such as drivers and mechanics were the most commonly afflicted. There was an abrupt transition from the old conservative methods of treatment to complex urethroplasties within the study period.

Comparing complications of urethral stricture across various ages: a retrospective analysis of findings from retrograde urethrogram and voiding cysto-urethrogram over 10 years

“…The age distribution of patients in this study is similar to that from studies from other parts of Nigeria [13–15] and beyond [16, 17]. Though all age groups are involved, there is a predominance of men in the middle ages.…”

Predictors of urethral stricture recurrence following urethroplasty: a retrospective review at the Jos University Teaching Hospital, Nigeria

“…It is pertinent to state at this point that, literatures directly evaluating the place of the surgeons' expertise, vis-à-vis the experience of the surgeons are sparse. Most studies focus mainly on preoperative and post-operative characteristics [2, 3, 6, 7, 14-17]. In this study, attempts have been made to identify some predictive factors for urethral stricture recurrence.…”

Prise en charge du rétrécissement urétral acquis: expérience du Service de Chirugie Générale de Sikasso

“…Comme dans d'autres séries Africaines [6, 7], nous avons une proportion importante (56,52%) de rétrécissement d'origine infectieuse, confirmée par une prédominance de l'atteinte bulbaire, zone où le cul de sac bulbaire et la densité élevée des glandes péri-urétrales favorisent la stagnation et la prolifération des germes. Nous constatons une certaine conformité entre nos résultats et la littérature, où la forte prévalence de la forme compliquée des rétrécissements sclerospongieux en milieu tropical africain résulte très souvent d'un retard de PEC, retard du probablement aux difficultés d'accès en soins spécialisés, à l'automédication et aux croyances traditionnelles néfaste.…”