Increasing utilization of urethroplasty for male urethral stricture disease: analysis of in-hospital interventions in Germany from 2006 to 2023.

PURPOSE: There is a wide range of surgical treatments for urethral strictures. There is no information on the extent to which these procedures have been used over the past few years.

METHODS

We analyzed data from Diagnosis Related Groups (DRG) billing data from DESTATIS. Linear regression models were utilized for the analysis of trends over time.

RESULTS

A significant decrease of male urethral stricture cases during the study period was observed. Cases decreased from 48,020 cases in 2006 to 33,062 cases in 2023, i.e. -31%. This decline was mainly driven by the decrease in cases in the younger age group (≤ 79 years), whereas a significant increase was noted in octogenarians (+ 24%). A total of 834,476 procedures for urethral stricture disease were analyzed. In accordance with total case numbers, inpatient surgical interventions for urethral stricture disease decreased by 39% during the study period. Internal urethrotomy significantly decreased by 50% (from 41,443 in 2006 to 20,777 in 2023; p < 0.001). Likewise, urethral dilatations significantly decreased by 17% (from 14,134 in 2006 to 11,674 in 2023; p = 0.002). On the contrary, urethroplasties significantly increased by 156% (from 873 in 2006 to 2,239 in 2023; p < 0.001).

CONCLUSION

We present contemporary data on urethral stricture disease management in Germany. Case numbers of internal urethrotomies and urethral dilatations are declining while urethroplasty is increasingly utilized as a definitive treatment for urethral stricture disease. This may reflect an optimized treatment of urethral strictures with more urethroplasties and thus fewer relapses to be treated.