Urethroplasty practices among reconstructive urologists in Nigeria

Abstract

Objectives:To determine the national practice patterns in the management of male urethral stricture disease by the open urethroplasty technique.Materials and Methods:A questionnaire-based national survey of Nigerian urologists was performed during the 19th Annual General Meeting and Scientific Conference of the National Association of Urological Surgeons of Nigeria, held at Ibadan, Southwest Nigeria in 2013.Results:A total of 55 respondents (67.1%) completed the questionnaire. About 43.6% were between the ages of 40 and 49 years. Almost 41.8% had between 5 and 9 years of experience as a reconstructive urologist, and 50.9% performed 1–9 urethroplasties/year. A total of 80 responders reported trauma as the most common etiology for their strictures. About 63.7% preferred to treat strictures after 3–6 months of diagnosis and 67.3% of respondents preferred the combination of retrograde urethrography and voiding cystourethrography for the diagnosis of urethral stricture. Stenting of the urethra was done after urethroplasty using size 16 Fr of 18 Fr silastic catheter; however, the duration of stenting varied among urologists. About 41.8% followed up their patients for a year, and uroflowmetry was used by 36.6% of the responders to follow-up their patients. Stricture recurrence was the most common reported complication by 36.4% of the respondents.Conclusions:In Nigeria, most urethral stricture diseases are treated by open urethroplasties. Very few of these surgeries are performed annually by young urologists. There is no uniformity in the method of diagnosis, stenting, and follow-up after treatment.

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

“…The proportion of stricture resulting from trauma is higher than strictures from post infective cause (Table 1). This is similar to reported urethral stricture aetiology in the literatures from sub-Saharan Africa [5, 8-10]. The rate of urethral stricture recurrence in this study was 25%, which is similar to that reported by Bello et al [3] which puts the recurrence rate at 27.8%.…”

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

“…Before then, most of the patients had either urethral dilatation or anastomotic urethroplasty or both, the failed dilatation often preceding the urethroplasty. Dilatation, the first treatment for urethral stricture, is palliative[ 1 ] and similar to direct vision internal urethrotomy[ 29 ] may actually worsen the stricture. [ 3 ] The unit currently reserves dilatation for short-segment urethral stricture occurring concurrently with benign prostatic hyperplasia so that both can be treated at the same operating session.…”

“…The urethra measures about 16 to 22 cm in the adult males and 4 cm in the adult females. [ 1 ] In males, it is anatomically divided into posterior and anterior segments. The posterior segment, traditionally referred to as the posterior urethra, measures about 4 cm and traverses the prostate and pelvic membrane beginning at the bladder neck.…”

Buccal mucosal graft urethroplasty for proximal bulbar urethral stricture: A revisit of the surgical technique and analysis of eleven consecutive cases

“…The management of the oral wound has been a subject of discussion and opinion varies as to whether the wound should be closed or not. 17 The oral wound was left open and packed with wet gauze in the authors' practice. The maximum duration of packing (compression) in this study was 48 h and thereafter, hexethidine mouth wash 18 was done after each meal.…”