Men Urethra Strictures: Findings in Urethroplasties Care at the Andrology and Urology Department of Grand Yoff General Hospital in Dakar

Abstract

Objectives: To report the experiment conducted at the HOGGY Urology department in the management of urethral stricture by urethroplasty, and to determine the factors that influence the results. Material and Method: We conducted a descriptive and analytical retrospective study based on the records of patients who underwent urethroplasty in the department, between February 2001 and September 2013. Results: Ninety-one (91) patients were enrolled. Urethroplasties prevalence was 0.83% of the surgical activity of the service. The mean age of patients was 39.83 years. Dysuria (30.77%) followed by pelvic trauma (28.57%) and urinary retentions (25.27%) was the main discovery mode. A periurethral coating was found in 32 patients. The infectious etiology accounted for 44% of cases. In 63% of cases, diagnostic was made by retrograde cystography. The penile urethra was the favorite seat of the UR in 70% of cases. The average length of the urethral stricture (US) was less than 1 cm in 41.17% of cases. The US was unique in more than half of the cases (58.33%). Anastomotic urethroplasty was the best surgical technique with 73.63% of patients. Postoperative morbidity involved 47 patients and was dominated by urinary infections (36 year old). The average duration of follow-up of operated patients was 29 months. After 6 months of follow-up, the best results were obtained with the termino-terminal urethroplasty technique with 62.5%. After a follow-up of 4 years, the success rate was 58.24%. The length of the stenosis and the allocation of gestures on the urethra were the two factors of failure. Conclusion: Stenosis is common in our regions. Treatment results are disappointing. Urethroplasty is the gold standard of surgical treatment and anastomotic urethroplasty gives better results.

Prise en charge du rétrécissement urétral acquis: expérience du Service de Chirugie Générale de Sikasso

“…En effet, la dilatation rétrograde itérative donne de très bon résultat lorsqu'il s'agit de rétrécissements perméables, courts et uniques dont l'atteinte concerne très souvent la muqueuse, le tissu spongieux généralement épargné. Avec (94,44%) de bon résultat, conformément à la littérature [11, 12] la RAT-T apparait comme la meilleure technique, quelque soit l'étiologie. Mais le délai minimum de 3 mois post traumatique doit être respecté dans les rétrécissements traumatiques.…”