One-Stage Urethroplasty for Strictures in Maiduguri, North Eastern Nigeria

Background. Urethral stricture is a frequent cause of lower urinary tract obstruction worldwide. The aim of this study is to present our experience with one-stage urethroplasty. Methods. All males that underwent one-stage urethroplasty between January 2001 and December 2010 were retrospectively reviewed. Details of their biodata, clinical presentation, diagnostic investigations, operative treatment, postoperative complications, and other outcome of surgery were extracted and analyzed. Results. Ninety-one patients aged 8–76 years, (mean; 4 5 . 6 ± 1 9 . 7 ) with urethral stricture were studied. Postinfective strictures accounted for 58.2% and postprostatectomy strictures for 3.3%. Twenty-six (27.9%) of the strictures were in the posterior urethra of which 18 (59.2%) were posttraumatic. Fifty-seven strictures (61.3%) were in the anterior urethra of which 51 (54.8%) were postinfective. Thirty-nine (42.9%) patients had end to end anastomosis, 29 (31.9%) flap augmentation and 17 (18.7%) tabularized flap substitution, and 6 (6.6%) dorsal onlay grafts (5 with buccal mucosa and 1 with penile skin). There were 18 (19.8%) cases of wound infection, 12 (13.2%) of restricture and 6 (6.6%) cases of urethrocutaneous fistula. Satisfactory urinary stream was found in 77 (84.6%) patients. There was no mortality. Conclusion. Infection is the commonest cause of urethral stricture followed by trauma, and one-stage urethroplasty give excellent results. 1. Introduction A urethral stricture is caused by narrowing of the urethral lumen due to spongiofibrosis, resulting in loss of distensibility and compliance, leading to poor urinary stream which may lead to further complications. It is a common problem worldwide affecting mainly the male urethra [1]. The aetiology of acquired urethral strictures varies from inflammatory causes to traumatic scarring after blunt perineal/pelvic trauma and iatrogenic causes following surgery or urethral catheter use [2, 3]. Most postinfective strictures are located in the anterior urethra (bulbopenile), whereas posttraumatic strictures affect the bulb or cause posterior urethral disruption or distraction the latter is a serious challenge to the urologist, because they are often associated with significant complications including incontinence and erectile dysfunction [4]. Various forms of repair of the urethra have been developed and perfected over the years, ranging from excision and end-to-end anastomosis in short segment strictures to substitution urethroplasty in long segment strictures. The aim is to produce a wider, stable, and more