Management Of Urethral Strictures In The UCTH Calabar.

Forty-five consecutive cases of urethral stricture seen in a single unit over a three-year period (May 2000-April 2003) were studied to determine mode of presentation, symptoms on presentation, cause of the stricture, course of the illness and the outcome of treatment. Thirty-nine patients were treated while 6 were lost to follow up before definitive therapy could be given. Most of the patients were adult males in their prime of life. Strictures were as a result of urethritis in 24 (53.3%) cases, trauma in 16 (35.6%) cases, indwelling catheter in 3 (6.6%) cases and of uncertain aetiology in 2 (4.4%) cases. Three of the post-traumatic cases were post prostatectomy. Definitive treatment was by urethroplasty in 28 (62.2%) patients, bouginage in 11 (24.4%) patients.. Results of treatment were classified as 'GOOD' or 'POOR' based on patients' judgement of improved flow, observed improvement of flow and comparison of urethrogram results, before and after treatment. Of the 28 patients treated by urethroplasty, 21 (75%) had 'GOOD' outcome while in 7 patients (25%) the outcome was 'POOR'. In the bouginage group, outcome was 'GOOD' in 63.6% (7/11) of patients, 'POOR' in 27.3% (3/11), while one patient died from septic complications. It is concluded that urethroplasty gives overall, better results in management of strictures, but dilatation remains a viable option in carefully selected cases and that urethritis is still a foremost aetiological factor for urethral strictures in Calabar.