The Management of Urethral Strictures and Stenoses at the John F. Kennedy Medical Center
International Journal of Clinical Urology
Volume 3, Issue 1, June 2019, Pages: 1-5
Received: Jan. 6, 2019;
Accepted: Jan. 29, 2019;
Published: Feb. 19, 2019
Views 497 Downloads 70
Ayun Cassell III, Department of Surgery, John F. Kennedy Referral and Teaching Hospital, Monrovia, Liberia
Bashir Yunusa, Department of Surgery, John F. Kennedy Referral and Teaching Hospital, Monrovia, Liberia
Edet Ikpi, Department of Surgery, John F. Kennedy Referral and Teaching Hospital, Monrovia, Liberia
Swalliho Sheriff, Department of Surgery, John F. Kennedy Referral and Teaching Hospital, Monrovia, Liberia
Weh-Wesseh, Department of Surgery, John F. Kennedy Referral and Teaching Hospital, Monrovia, Liberia
Solomane Konneh, Department of Surgery, John F. Kennedy Referral and Teaching Hospital, Monrovia, Liberia
Follow on us
Background: A urethral stricture is an abnormal narrowing of the urethra resulting from fibrosis in the surrounding corpus spongiosum. The prevalence is estimated to be 229–627 per 100,000 males and its effects on the quality of life of those with the disease are far-reaching. Documented male-to-female ratio in Port-Harcourt, Nigeria, showed a ratio of 31:1 indicating that urethral stricture is very rare in females. Objective: The objective of the study is to assess the approach and outcome of the management of urethral stricture and stenosis at the John F. Kennedy Medical Center. Material and Methods: This is a 7-month retrospective descriptive study assessing the management of 20 patients with urethral stricture at the John F. Kennedy Medical Center from January 2018 to August 2018. The patient’s medical records were retrieved form the record department and reviewed for age, etiology of urethral stricture, site of urethral stricture, procedure performed and postoperative complications. Result: A total of 20 male patients with urethral stricture or stenosis were included in the study. Study revealed that the predominant etiology of urethral stricture was post-traumatic accounting for 35% (7/20). Gonoccal urethritis caused urethral stricture in 30% (6/20) of patients while instrumentation was 20% (4/20). Most of the post-inflammatory stricture involved the bulbar urethra as well as the penile urethra. Urethral Dilatation 9/20 (45%) and resection plus end to end anastomotic urethroplasty 35% (7/20) were the procedures commonly used to manage urethral strictures mostly the bulbar and bulbo-penile parts of the urethra. Conclusion: Urethral stricture disease is a common cause of urological presentation to the urologist worldwide. Urethral dilatation is most commonly performed for urethral strictures due to its feasibility and much less technical challenge. The failure rate is nonetheless high therefore, urethroplasty remains the standard option if possible. Appropriate traffic regulations, judicious use of catheters and proper treatment of urethritis could reduce the incidence of urethral stricture disease.
Anastomosis, Post-Inflammatory, Trauma, Urethral Stricture, Urethroplasty
To cite this article
Ayun Cassell III,
The Management of Urethral Strictures and Stenoses at the John F. Kennedy Medical Center, International Journal of Clinical Urology.
Vol. 3, No. 1,
2019, pp. 1-5.
Copyright © 2019 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/
) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Latini JM, McAninch JW, Brandes SB. Consultation on Urethral Strictures: Epidemiology, etiology, anatomy, and nomenclature of urethral stenoses, strictures, and pelvic fracture urethral disruption injuries. Urology 2014; 83: S1-7.
Oranusi CK, Nwofor A, Orakwe JC. Urethroplasty practices among reconstructive urologists in Nigeria. Niger J Surg 2015; 21: 146‑50.
Ivaz SL, Bugeja S, Andrich DE. Urethral stricture disease in men. Trends Urol Mens Health 2015; 6:21‑4.
Chapple C, Barbagli G, Jordan G, Mundy AR, Rodrigues-Netto Korean J Urol 2013; 54: 561-569N, Pansadoro V, et al. Consensus statement on urethral trauma. BJU Int 2004; 93: 1195-202.
Lee YJ, Kim SW. Current management of urethral stricture. Korean J Urol 2013; 54: 561‑9.
Wessels H. Ventral onlay graft bulbar urethroplasty using buccal mucosa. Afr J Urol 2016; 22: 40‑6.
Santucci RA et al. Male urethral stricture disease. J Urol. 2007; 177 (5): 1667-74.
NHS Digital. UK NHS hospital episode statistics. Available at http: //www.hesonline.nhs.uk. Last accessed: 2 January 2018.
Ekeke ON, Amusan OE. Clinical presentation and treatment of urethral stricture: Experience from a tertiary hospital in Port Harcourt, Nigeria. Afr J Urol. 2016; 23 (1): 72-7.
Dakum NK et al. Outcome of urethroplasty for urethral stricture at Jos University Teaching Hospital. Niger J Clin Pract. 2008; 11 (4): 300-4.
Hampson LA et al. Male urethral stricture and their management. Nat Rev Urol. 2013; 11 (1): 43-50.
Wessells H. Ventral onlay graft bulbar urethroplasty using buccal mucosa. Afr J Urol. 2016; 22 (1): 40-6.
Zimmerman WB, Santucci R. Buccal mucosa urethroplasty for adult urethral stricture. Indian J Urol. 2011; 27: 364-70.
Attah CA, Mbonu O, Anikwe RM. Treatment of urethral strictures in University of Nigeria Teaching Hospital. Urology 1982; 20: 491‑4.
Singh O, Gupta SS, Arvind NK. Anterior urethral strictures: a briefreview of the current surgical treatment. Urol Int 2011; 86: 1–10.
Lumen N, Hoebeke P, Willemsen P, De Troyer B, Pieters R, Oosterlinck W. Etiology of urethral stricture disease in the 21st century. Journal of Urology 2009; 182 (3): 983–7.
Fenton AS, Morey AF, Aviles R, Garcia CR: Anterior urethral strictures: etiology and characteristics. Urology 2005; 65: 1055–8.
Ahmed A, Kalayi GD. Urethral stricture at Ahmadu Bello University Teaching Hospital, Zaria. East African Medical Journal 1998; 75 (10): 582–5.
Barbagli G, Kulkarni SB, Fossati N, Larcher A, Sansalone S, Guazzoni G, et al. Long-term followup and deterioration rate of anterior substitution urethroplasty. J Urol. 2014; 192: 808-13.
Mehmet Akyuz, Zulfu Sertkaya, Orhan Koca, Selahattin Calıskan, Adult urethral stricture: practice of Turkish urologists Vol. 42 (2): 339-345, March - April, 2016.
Andrich DE, Mundy AR: What is the best technique for urethroplasty? Eur Urol 2008; 54: 1031–41.