OBJECTIVETo report a quantitative and qualitative histological analysis of spongiosum tissue in patients with bulbar urethral strictures. MATERIALS AND METHODSUrethral specimens from 15 patients who had end-to-end anastomotic urethroplasty were evaluated; the control group comprised five bulbar urethras from cadavers. The collagen content, elastic fibres, smooth muscle and vessels were analysed using stereological methods. RESULTSThere was complete loss of the relationship between smooth muscle, extracellular matrix and sinusoids in the peri-luminal area (PLA), with collagen replacement. The extension of the fibrotic area was greater in those with a traumatic than in those with an atraumatic stricture. The content of smooth muscle and collagen in the peripheral spongiosum (PS) area was similar for the stricture and control groups, and results were comparable for traumatic and atraumatic groups and those with suprapubic cystostomy diversion or not before surgery. There was a remarkably lower vascular density in the traumatic than in the atraumatic group. There was an increase in type III collagen in the PLA and in type I collagen in the PS; collagen type III in the PLA was greater in the group with no suprapubic cystostomy diversion before surgery. There were fewer elastic fibres in both stricture areas (PLA and PS) than in the control group. CONCLUSIONSUrethral stricture formation is characterized by marked changes in extracellular matrix features, with consequent changes in organ function.

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Health and Human Services, and ranged from 0.3/100,000 (Region 2, New York) to 2.2/10,000 (Seattle) (Pearson Chi-Square Ͻ.0001).CONCLUSIONS: In the Department of Defense's equal-access health care system, 1.4/100,000 males evaluated had LS. Cases of LS appear to be more frequent among white males, especially after the third decade of life. There may also be a difference in the likelihood of diagnosis by geographic region with more cases of LS occurring in the Western United States. Additional analyses are needed to explore these highly provocative findings more thoroughly.