Short-term recurrence rate of male urethral stricture and its predictors after treatment with optical internal urethrotomy: Prospective Cohort Study at a tertiary center in Ethiopia

Abstract

Abstract Background Even though, one of the managements options of urethral stricture, popular among the urologists in view of its simplicity, safety and shorter learning curve is Optical Internal Urethrotomy (OIU), urethroplasty should be offered as the gold standard treatment option for urethral stricture. The main aim of our study is to determine the one-year recurrence rate of urethral stricture after treatment with optical urethrotomy and identify predicting factors of urethral stricture recurrence at a tertiary centre in Ethiopia. Materials and Methods A prospective observational cohort study was conducted on 80 male patients who underwent optical urethrotomy for urethral stricture from November 2019 to August 2020 G.C. in a tertiary center in Ethiopia. Logistic regression was used to analyze the association between dependent and independent variables. A p-value of <0.05 was considered statistically significant. Results The mean age (± SD) of patients at the time of the procedure was 54.76 (± 14.74) years with a range [20-78]. Urethral discharge was the most common etiology identified in 39 (48.75%) of patients. Eleven (13.75%) patients had no identifiable etiology for their urethral stricture disease. Majority of patients presented with at least one voiding lower urinary tract symptoms (LUTS). Sixty-eight (85%) patients out of the total had single stricture and 12 (15%) had multiple strictures. The location of stricture was in the bulbar urethra on CUG in 83% of the patients. The one-year recurrence rate of urethral stricture after optical urethrotomy was 35%in our study. Number of strictures and presence of hypertension were independent predictors of recurrence of urethral stricture within one year after treatment with optical urethrotomy [AOR=15.35(2.92-80.61) at 95% CI; P=0.00] and [AOR=19.47(2.11-178.98) at 95% CI; P=0.01], respectively. Conclusions Our study identified that multiplestrictures, and presence of hypertension are associated with increased recurrence rate in the first post-operative year.