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.
Citation
Master of Medicine in Surgery, University of Nairobi, 2003Publisher
University of Nairobi. Faculty of Medicine