Risk factors for recurrence of urethral strictures in urology at the Cocody-Abidjan University Hospital in Ivory Coast from 2014 to 2023

Abstract

Objective: To identify factors that promote recurrence of urethral strictures.

Methods: This was a retrospective cohort study that included 104 patient records from the Urology Department of the Cocody-Abidjan University Hospital (CHU) for urethral strictures from April 1, 2014, to March 31, 2023, a period of 10 years.

Results: The prevalence of urethral strictures was 3.20%, with a mean age of 54.45 years and a range of 17 to 90 years. More than half of the patients were from disadvantaged social classes. All patients presented with dysuria, 81% of which was associated with urinary retention. Strictures were post-infectious in 66% of cases and iatrogenic in 21% of cases. Endoscopic internal urethrotomy (EUI) was the most commonly used treatment in 45% of cases, followed by end-to-end anastomotic resections (ETAR) in 25%, 1-stage urethroplasty (1ST) in 14%, and 2- stage urethroplasty (2ST) in 11%. The recurrence rate was 32.7% (34/104). Infectious causes dominated the recurrence cases with 32 out of 34 cases. Patients who underwent EUI with 22 out of 34 cases had more recurrences. There was a statistically significant relationship between the occurrence of recurrence and infectious etiology There was also another significant relationship between previous treatment (endoscopy) and recurrence, with a chi-square value of 12.59 higher than the observed chi-square value of 10.18.

Conclusion: Urethral stricture affects adults and the elderly from disadvantaged backgrounds. EIU performed for infectious causes is marked by adverse outcomes, with a high recurrence rate.