Certain patients have an increased risk for complications from urethral stricture, according to new study findings presented at the Canadian Urological Association 74th annual meeting in Quebec City.
In a study of 1023 patients with urethral stricture (mean age 48) presenting to a single urologist during 2005 to 2016, 40.6% experienced at least 1 major complication, Keith Rourke, MD, of the University of Alberta in Edmonton, and his collaborators reported. About a third of patients had acute urinary retention, 16% had difficult catheterization, 5% suffered urethral abscess/urosepsis, 3.1% had kidney failure (3.1%), and 7% had life-threatening complications.
On multivariate analysis, absence of preceding lower urinary tract symptoms (LUTS), presence of posterior stenosis, traumatic stricture, and longer stricture were associated with significant 3.8-, 3.0-, 1.6-, and 1.1-fold increased risks for complications, respectively. Trauma or hypospadias as causes of stricture more than doubled the risk for potentially fatal complications.
Patients with high-risk characteristics should be strongly encouraged to have definitive treatment, Dr Rourke and his colleagues concluded in a study abstract.
In this cohort, stricture etiology was most commonly idiopathic (46.3%), iatrogenic (15.0%), or due to lichen sclerosus (14.9%). Mean stricture length was 5.0 cm and most commonly occurred in the bulbar (65.6%), penile (18.6%), multisegment (10.6%), and posterior (5.4%) regions of the urethra.
King C and Rourke KF. Urethral stricture is frequently a morbid condition: Identifying patients at increased risk for complications due to urethral stricture. Presented at the 2019 Canadian Urological Association 74th annual meeting held June 29-July 1 in Quebec City. Abstract MP-1.10.