Reconstructive UrologyContemporary Urethral Stricture Characteristics in the Developed World
Section snippets
Material and Methods
A retrospective study was performed in our Italian referral center for urethral reconstruction to analyze the whole database of male patients with urethral stricture who had undergone surgical treatment from 2000 to 2010, regardless of age.
A total of 1439 patients were diagnosed, evaluated, and surgically treated by the same urologist (E.P.). The preoperative evaluation included a detailed clinical history of the urethral stricture disease, physical examination, uroflowmetry, retrograde and
Results
Of the 1439 patients, 1402 (97.4%) underwent urethroplasty and 37 (2.6%) internal urethrotomy. The main characteristics of the study data set are listed in Table 1.
Most Common Stricture Site
Our findings have confirmed that urethral stricture in developed countries mainly involves the anterior urethra (92.2%), in particular, the bulbar tract (46.9%), with the posterior urethra involved only in 7.8% of cases.5, 6, 8 This explains why general urologists manage mainly bulbar strictures and, more rarely, penile strictures. The rarest posterior strictures are treated in highly specialized centers.7
Current Most Common Stricture Etiology
Past reports on stricture etiology have been characterized by small series of patients.
Conclusion
Our findings have shown that urethral stricture in developed countries mainly involves the anterior urethra, in particular, the bulbar tract. The most common cause of stricture formation was iatrogenic; thus, particular care must be taken when handling the urethra. HR and LS represented important emerging causes, responsible for most penile and panurethral strictures, which are also commonly acknowledged as the most difficult to treat. Finally, urethral stricture is not a disease of the elderly
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Financial Disclosure: The authors declare that they have no relevant financial interests.