Short-term recurrence rate of male urethral stricture and its predictors after treatment with optical internal urethrotomy: Prospective Cohort Study at a tertiary center in Ethiopia

Abstract Background: Even though, one of the managements options of urethral stricture, popular among the urologists in view of its simplicity, safety and shorter learning curve is optical internal urethrotomy , urethroplasty should be offered as the gold standard treatment option for urethral stricture. The main aim of our study is to determine the one-year recurrence rate of urethral stricture after treatment with optical urethrotomy and identify predicting factors of urethral stricture recurrence at a tertiary centre in Ethiopia. Materials and Methods: A prospective observational cohort study was conducted on 80 male patients who underwent optical urethrotomy from November 2019 to August 2020 G.C. in a tertiary center in Ethiopia. Logistic regression was used to analyze the association between dependent and independent variables. A p-value of <0.05 was considered statistically significant. Results: The mean and median age (± standard deviation) of patients at the time of the procedure were 54.76 (± 14.74) and 58 years with a range [20-78], respectively. Urethral discharge was the most common etiology identified in 39 (48.75%) of patients. Eleven (13.75%) patients had no identifiable etiology for their urethral stricture disease. Majority of patients presented with at least one voiding lower urinary tract symptoms . Sixty-eight (85%) patients out of the total had single stricture and 12 (15%) had multiple strictures. The location of stricture was in the bulbar urethra on cysto-urethrography in 83% of the patients. The one-year recurrence rate of urethral stricture after optical urethrotomy was 35% in our study. Number of strictures and presence of hypertension were independent predictors of recurrence of urethral stricture within one year after treatment with optical urethrotomy [AOR=15.35(2.92-80.61) at 95% CI; P=0.00] and [AOR=19.47(2.11-178.98) at 95% CI; P=0.01], respectively. Conclusions Our study identified that multiple strictures, and presence of hypertension are associated with increased recurrence rate in the first post-operative year.