Male urethral stricture disease in a tertiary hospital in Port Harcourt, Nigeria: a five-year review of features, management and outcome

Introduction: The aim is to assess the early impact of the current increased use of transurethral endoscopic procedures and emerging technologies on the management of urethral stricture disease (USD) in adult males at the University of Port Harcourt Teaching Hospital (UPTH), Nigeria.
Material and Methods: The design of the study was cross-sectional and descriptive. Secondary data of patients treated between 01/6/2017 to 30/6/2022, with confirmed diagnosis of USD were used. Their registration numbers were used to access their records at the Health Records Department of the Hospital. Information obtained included sociodemographic data, aetiology, clinical features, types, sites and diagnostic tests of male USD, , uroflowmetry, urethral, and abdominopelvic ultrasonography, cystourethrography results, treatment methods, outcomes, complications and co-morbidities of USD. Data obtained were analyzed with simple statistics and presented. 
Results: Of 10,450 Urology patients 245 had USD. Data on 224 were found and analyzed. Their age profiles in years were mean, 45.7±18.6; age range 10-95. Married were 174 (77.68%).
Urethral strictures were post inflammatory 126(56.25%); post traumatic 43.75%; bulbar,73(32.59%); bulbomembranous23.22%; posterior urethral 52(23.21%); penile 34(15.18%); and pan urethral 13, (5.18%). At presentation, 105 (46.88%) were hypertensive; 40.2% had UTI with Gram-negative bacilli.
Recurrence of strictures occurred 6 months to one year after DVIU; 2 months to 6 years after urethroplasty. Non-compliance with schedules and follow-p occurred in 111 (49.55%) patients.
Conclusion: USD prevalence was 24/1000 urology patients. UTIs were probably healthcare and prolonged catherization associated. Screening/review of service processes warranted. Lack of validated tools for measurement of outcome or dependent treatment variables made comparative studies unrealistic.