The Changing Trend in Clinical Characteristics and Outcomes of Male Patients With Urethral Stricture Over the Past 10 Years in China

Abstract

Background: Male urethral stricture is a disease with a high incidence rate. With social-economic development in the developing countries, the trend of etiology and treatment of male urethral stricture changed was speculated.Methods: The clinical data of the male patients with urethral stricture from 2000 to 2019 were analyzed. The subjects were divided into Group A (2000–2009) and Group B (2010–2019) according to treatment time. The pooled analysis of the data extracted from pieces of literature was also performed.Results: About 540 patients were included in the present study, including 235 patients in Group A and 305 patients in Group B. In recent 10 years, trauma has still been the main cause of urethral stricture. Iatrogenic injury, especially transurethral operation, increases significantly, while male urethral stricture secondary to radiotherapy and infection decrease. Urethroplasty increases and the reoperation rate decreases in treating simple urethral stricture, and flap urethroplasty also increases in treating complex urethral stricture. The results of a pooled analysis of data from 11 centers in Mainland China are partially consistent with it. Complications, such as urethral fistula, false canal, ejaculation disorder, and penile curvature, decrease significantly.Conclusions: The main causes of urethral stricture in the recent 10 years are still trauma and iatrogenic injuries, and the etiology of urethral stricture is related to socioeconomic development. With the increase of intracavitary minimally invasive treatment and flap urethroplasty, the curative effect is increasing, while iatrogenic urethral stricture cannot be ignored.

Overexpressed miR‐486 in bone marrow mesenchymal stem cells represses urethral fibrosis and targets Col13a1 in urethral stricture rats

“…US is featured with fibrosis of tissues surrounding the urethral lumen and results in obstructive symptoms, which adversely affect patients' quality of life 2 . The etiology of US can be divided into four categories: trauma, inflammation, idiopathic and iatrogenic injury, among which trauma and iatrogenic injury are the most common causes of US in China 3 . With the development of modern techniques, various treatment options are available for US such as urethral dilatation, internal urethrotomy, and open urethroplasty 4 .…”

“… 2 The etiology of US can be divided into four categories: trauma, inflammation, idiopathic and iatrogenic injury, among which trauma and iatrogenic injury are the most common causes of US in China. 3 With the development of modern techniques, various treatment options are available for US such as urethral dilatation, internal urethrotomy, and open urethroplasty. 4 Urethroplasty is considered the gold standard of US treatment, with higher success rates than dilatation or urethrotomy.…”

Pharmacotherapy of urethral stricture

“… 5 Most cases of urethral stricture occur in the anterior part of the urethra (92%), especially at the bulb. 6 7 8 It has been established that urethral stricture makes urination difficult at any age and causes irreversible damage to the entire urethra over time, severely impacting patients’ quality of life. 9 …”