Epidemiological, Diagnostic, Therapeutic Prognostic and Analytical Aspects of Urethral Stricture at the University Clinic of Urology-Andrology of the CNHU HKM of Cotonou from 2012 to 2023

Abstract

Introduction: Urethral stricture is the dominant cause of obstructive pathology of the lower urinary tract. This condition results from several mechanisms and can be the source of several serious complications, including renal failure, urinary tract infections, and urinary stones. This study aims to review the diagnostic, therapeutic, and prognostic aspects of urethral strictures at the CNHU-HKM in Cotonou over the past twelve years. Patients and Methods: This was a retrospective, descriptive, and analytical cross-sectional study examining the epidemiological, diagnostic, therapeutic, and prognostic aspects of urethral strictures at the CNHU-HKM in Cotonou from 2012 to 2023, which took place from December 28, 2023 to January 24, 2024. Results: The study involved 119 medical records, representing an annual frequency of 9.91 cases. The male sex predominated (98.23%). The average age of the patients was 47.5 years, with extremes of 7 years and 88 years. 91.23% of the cases were from Benin. Dysuria was the most frequently found sign (68.04%). A history of urethral stricture was found in 19.30% of patients. On the paraclinical level, UCRM was the most frequently performed examination (75.63%). The anterior urethra was the most frequent site of strictures (55.46%) with a strong propensity at the level of the bulbar segment (27.73%). Compared to the impact assessment, the ECBU was positive in 24.36% of patients and the most common colonies were successively: Escherichia coli (37.93%), followed by Klebsiella pne umonia (23.08%) and Enterobacter clocae (11.54%). A GFR < 15 ml/min/1.73m 2 was observed in 10.20% of patients, indicating end-stage renal impairment. Urethral strictures were of infectious (57.02%), traumatic (27.19%), and iatrogenic (15.79%) origin. In terms of treatment, endoscopic internal urethrotomy (31.93%) was the most common technique. The average hospital stay was 19.48 days, ranging from 1 to 280 days. The duration of urethrovesical catheterization was 18.56 days, ranging from 3 to 56 days. Regarding outcome, 41.18% of patients were lost to follow-up after expulsion. At hospital discharge, 33.61% of patients had regained comfortable urination. On the other hand, 16.80% of patients had at least one recurrence after 12.6 months. Currently, 5.88% still have a cystostomy catheter and 28.57% of patients contacted by phone still have normal and comfortable urination. Conclusion: Urethral stricture is a pathology affecting all ages, with multiple etiologies and a serious nature due to its recurring nature.