Reconstructive UrologyThe Clinical Spectrum of the Presenting Signs and Symptoms of Anterior Urethral Stricture: Detailed Analysis of a Single Institutional Cohort
Section snippets
Material and Methods
Institutional ethics board approval was obtained for this retrospective review. The complete health records of patients presenting for evaluation and management of anterior urethral stricture over a 6-year period were analyzed. All pertinent institutional data, referring physician, and office records were abstracted into a database and screened by 2 separate individuals to identify potential issues regarding data inconsistencies or integrity. This study cohort was composed of patients with true
Results
Six-hundred eleven patients met the study criteria with all presenting, and associated signs and symptoms information available for analysis All patients underwent cystoscopy to confirm the clinical diagnosis of urethral stricture, and 591 patients (96.5%) underwent retrograde urethrography as a further staging modality. Mean patient age was 48.9 years (range 6-91). Stricture length was an average of 5.7 cm as staged by retrograde urethrography. Stricture etiology was most commonly idiopathic
Comment
It is assumed by many that “most patients (with urethral stricture) present with progressive symptoms of lower urinary tract obstruction.”2 Despite a paucity of data examining this assumption, it has widely impacted the clinical practice of urethral stricture, including evaluation, treatment, and follow-up.4 Over the last 20 years, care of the patient with urethral stricture has evolved from a mostly endoscopic approach to one in which open urethroplasty can successfully achieve long-term
Conclusions
Although many patients with urethral stricture present with LUTS or AUR, almost one-quarter of patients have a different presenting complaint. Defining a successful outcome after treatment for anterior urethral stricture should include more than improvement in LUTS or absence of urinary retention. In addition, urethral stricture is not solely a “quality of life” condition, because >50% of patients require emergent urologic treatment and 7.4% have a life-threatening condition directly related to
References (22)
- et al.
Male urethral stricture disease
J Urol
(2007) - et al.
Stricture recurrence after urethroplasty: A systematic review
J Urol
(2009) - et al.
Internal urethrotomy in the management of anterior urethral strictures: long-term followup
J Urol
(1996) - et al.
Internal urethrotomy versus dilation as treatment for male urethral strictures: a prospective, randomized comparison
J Urol
(1997) - et al.
Treatment of male urethral strictures: is repeated dilation or internal urethrotomy useful?
J Urol
(1998) - et al.
Primary urethral reconstruction: the cost minimized approach to the bulbous urethral stricture
J Urol
(2005) - et al.
Repeat urethrotomy and dilation for the treatment of urethral stricture are neither clinically effective nor cost-effective
J Urol
(2004) - et al.
Urethroplasty for stricture disease—what is success beyond the voiding function?
Eur Urol
(2008) - et al.
Defining a patient-reported outcome measure for urethral stricture surgery
Eur Urol
(2011) - et al.
American Urological Association symptom index in the assessment of urethroplasty outcomes
J Urol
(1998)
Cited by (53)
Prospective Assessment of Genital Pain in Patients With Urethral Stricture: Incidence, Associations, and Impact of Urethroplasty
2023, UrologyCitation Excerpt :In the setting of urethral stricture, genital pain could potentially be directly related to the stricture or due to referred pain. In some patients, the urethral stricture itself may be inflamed and could act as a direct source of pain in either the penis or scrotum depending on stricture location and length.3 It has been previously identified that “local pain” on palpation can occur in up to 17% of patients with urethral stricture.8
Recent Trends and Advances in Anterior Urethroplasty
2022, Urologic Clinics of North AmericaCitation Excerpt :Thus, the term “stricture” is reserved specifically for fibrosis and coexistent narrowing within the anterior urethra from the urethral meatus to the proximal bulbar urethra.2 Although the prevalence has likely changed over the course of human history, urethral stricture remains a burdensome and increasingly common urologic condition, which causes a broad spectrum of associated signs, symptoms, and complications.3 Urethral stricture can occur as a result of 1 of 2 general mechanisms.
European Association of Urology Guidelines on Urethral Stricture Disease (Part 2): Diagnosis, Perioperative Management, and Follow-up in Males
2021, European UrologyCitation Excerpt :Postvoid dribble is present in 73% of cases [3]. Pain is also a common feature affecting 22.9–71% of patients [1,4]. Pain can be felt in the bladder and/or urethra and is associated with more significant LUTS.