A review on management procedures for urethral stricture disease at Kenyatta National Hospital

Abstract

This is a 5 year retrospective study that outlines the management procedures for urethral strictures and their outcome from January 1997 - December 2001 at Kenyatta National Hospital. It also highlights the causes, modes of presentation and investigations carried out for evaluation of the strictures. Data was collected from inpatient files of the patients who were diagnosed and managed during the study period. Files with no records of follow-up were excluded from the study. Atotal of 179 patients were included and had their details extracted through a proforma questionnaire. Raw data was tabulated and analysed in order to address the objectives of the study. Post traumatic strictures is found to be the commonest cause in 41.4% of the patients followed by post inflammatory strictures in 21.2%. Contrast urethrogram is found to be the commonest diagnostic tool used in 75.4% of the patients. The commonest modes of presentation is found to be difficulty in passing urine and indwelling suprapubic catheter in 42% and 40.8% of the patients respectively. A total of360 procedures were performed during the study period of which 179 were during the initial management and 181 during the follow-up. Overall passage of sounds CPOS) was the commonest procedure performed in 32.2% of the cases followed by direct visual urethrotomy CDVU) in 28.9% and anastomatic urethroplasty in 20.6%.Other procedures accounted for 18.3%. In the initial management anastomatic urethroplasty was the commonest procedure in 33% of the patients followed closely by DVU in 29.1 % and POS in 26.3% of the patients while other procedures accounted for 11.6%. In the initial management, anastomatic urethroplasty had a better outcome than DVU and POS.