RESEARCH ARTICLE


Prevalent Practices in Male Anterior Urethral Stricture Management: A Survey



Suyog Shetty1, Suresh Bhat2, Anupam Choudhary3, *, B. M. Zeeshan Hameed1, Mummalaneni Sitaram3, Milap Shah3, Suraj Jayadeva Reddy3
1 Department of Urology, Father Muller Medical College, Father Muller Charitable Institutions, Mangalore, Karnataka, 575002, India
2 Department of Urology, Government Medical College Kottayam, Kerala, 686008, India
3 Department of Urology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India


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Creative Commons License
© 2022 Shetty et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

>* Address correspondence to this author at Department of Urology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Karnataka, 576104 India; Tel: +919880635885; E-mail: dranupamchoudhary86@gmail.com


Abstract

Objective:

This article aimed to study the prevalent practices in the treatment and follow-up of urethral strictures. Moreover, the article aimed to investigate the present opinion among urologists as the treatment practices for urethral stricture disease are mostly dependent on the treating surgeon’s expertise and preference in the absence of widely followed standard guidelines.

Methods:

A questionnaire was formulated based on the responses from experts. From October to December 2020, all members of the urological society of India received a mailed questionnaire on a web-based survey platform. Practicing urologists from across the country are among its members.

Results:

A total of 2554 urologists were contacted by mail, and 282 (11%) urologists provided a response. The majority were doing 5 to 15 urethroplasties a year. A newly diagnosed short segment bulbar urethral stricture would be a candidate for a visualized internal urethrotomy (VIU), according to 69.5% of urologists. Recurrence after one attempt at VIU prompted 80% to switch to urethroplasty as the next choice. During preoperative evaluation, 100% of respondents wanted a retrograde urethrogram, 74% deemed micturating cystourethrogram necessary, and 60% wanted a urethroscopy. At discharge, the majority preferred silicone Foley catheters, and the preferred size was 16F (54%). The patients were discharged with both suprapubic catheter and Foley in situ by most urologists. During follow-up, 60.99% wanted uroflowmetry, and the duration of follow-up varied.

Conclusion:

This survey on urethral stricture management amongst urologists shows that there is wide variation in the management of stricture urethra. This survey underscores the need for large-scale, long-term studies to formulate a guideline for the management of urethral stricture disease, thereby bringing uniformity in the care provided.

Keywords: Visualized internal urethrotomy, Urethroplasty, Uroflowmetry, Sonourethrogram, Stricture urethra, Catheters.