The new pattern of urethral stricture disease in Lagos, Nigeria.

OBJECTIVES

The study is a follow up to two separate studies done in this centre 42 and 20 years ago on the changing pattern of urethral stricture disease(USD). It assesses the aetiology,the general pattern and treatment outcome in our centre.

PATIENTS AND

METHODS

This is an 8 year review of all cases of USD managed at the Lagos University Teaching Hospital between January 1998 to December 2005. Diagnosis was confirmed mainly by urethrographic studies and occasionally by endoscopy. Data collected included age, sex, aetiology, site and length of stricture, treatment and outcome.

RESULTS

Eighty four patients (83 males and 1 female) with USD were seen within the period with a mean age of 43.1 years. Trauma was responsible for 60 (72.3%) cases, with road traffic accident topping the list with 29 (34.9%), with iatrogenic trauma now accounting for 17 (20.5%) of all cases of USD. Indwelling urethral catheter was responsible for 13 (76.5%) of iatrogenic cases. Purulent Urethritis was responsible for 22 (26.5%) of cases. Fifty (60.2%) cases were located in the anterior urethral while twenty three (39.8%) were in the posterior. Fifty seven patients had urethroplasty with a recurrence of 14% and 8 patients had urethral dilatation with 50% 1 year recurrence.

CONCLUSION

Trauma is now the undisputed leading cause of USD in our environment. The incidence of post catheterisation strictures has also risen rapidly. Increased safety on our roads, improvement in medical education and quality of urethral catheters are suggested by this study in order to reduce the incidence of USD.