Nigerian Journal of Surgery (Jan 2017)
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.
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