Results of Urethroplasty by Segmental Resection and End-to-End Anastomosis at the Urology Department of Hôpital De LA Paix, Ziguinchor: A Study of 45 Cases

Abstract

Introduction: Urethral stricture in men is an ancient condition and remains a frequent issue in urological practice. This pathology can have severe consequences on the upper urinary tract. Despite advances, its treatment continues to pose challenges, stimulating ongoing innovation and ingenuity among urologists, as evidenced by the multitude of available surgical techniques. The aim of our study was to evaluate the outcomes of urethroplasty by segmental resection and end-to-end anastomosis in the management of urethral strictures at the Urology Department of Hôpital de la Paix in Ziguinchor, Senegal. Methods: We conducted a retrospective and descriptive study from January 2017 to December 2021, spanning a 5-year period. The study included all male patients treated for urethral stricture using the technique of anastomotic urethroplasty. Results: We collected 45 cases. The mean age of the patients was 51.16 years (range: 15 - 85 years). Complete urinary retention was the most common reason for consultation, accounting for 60% of cases (n = 27). The majority of strictures were located in the bulbar urethra (60%, n = 27), with a mean length of 1.6 ± 0.9 cm (range: 0.5 cm - 4 cm). Infectious causes were predominant, representing 51.1% of cases (n = 23). A history of urethral instrumentation was reported in 37.7% of patients (n = 17). All patients underwent segmental urethral resection followed by end-to-end anastomosis. The mean duration of hospitalization was 5.2 ± 9 days. After a follow-up period of 21 ± 12 months [1 - 48 months], the average success rate was 73.3% (n: 33). The success rate for bulbar strictures was 85.7% (n = 24), and for strictures less than 2 cm in length, the success rate was 87% (n = 20). At 12 months of follow-up, long-term outcomes were more favorable for traumatic strictures (75%, n = 9) compared to infectious causes (50%, n = 8). Postoperative complications were predominantly infectious, with 11.1% wound suppuration and 8.9% urinary tract infections. No deaths were reported. Conclusion: Urethral stricture was predominantly caused by infection, highlighting the need for appropriate and optimal antibiotic therapy in urinary tract infections. The treatment of stricture remains a challenge for urologists.