Surgical management of male urethral stricutre at the Urology Department of Conakry, observations on 250 cases

Objective: To determine the indications for treatment of strictures of the male urethra and to evaluate the results achieved with the various techniques used at the Urology Department of the Conakry University Hospital, Republic of Guinea. Patients and Methods: In this retrospective study, 250 patient files covering a period of 5 years (January 1, 2000 – December 31, 2004) were reviewed. The therapeutic procedures used were internal urethrotomy (with or without urethral dilatation) and urethroplasty. The treatment results were evaluated taking into consideration clinical (micturition profile) and radiological criteria (intravenous urography and retrograde urethrocystography), as well as the need for urethral dilatation. Results: The majority of strictures were caused by infection followed by post-traumatic strictures accounting for 84.4% (n=211) and 10.4% (n=26), respectively. Urethral stricture was associated with other pathologies in 37.6% (n=94) of cases. Internal urethrotomy was the main procedure used in 82.8% (n=207) of patients followed by urethroplasty. After a follow-up period of 22 months, the results were satisfactory in 80% (n=200) of the cases. The best results were achieved in iatrogenic and post-infective strictures, with good results in 85.7% and 62.1%, respectively. Conclusion: The treatment of urethral strictures, be it endoscopic or surgical, is still associated with a high complication rate, and recurrence is not rare.African Journal of Urology Vol. 12 (4) 2006: pp. 200-20