The Radiological pattern of Male Urethral strictures in Nairobi

Abstract

Urethral stricture is one of the common causes of lower urinary tract obstruction in Africa. Its impact includes pain, disturbance in family and social life and complications include renal failure, and urethral carcinoma. The pattern of causes of urethral stricture are said to be changing with time. Up to early 1980s, infection especially gonococcal infection was the leading cause of urethral stricture. With advent of wide spread antibiotic use, changes in life style and advances in technology, trauma has become the commonest cause. Objective The main objective of this study is to determine the radiological pattern of male urethral strictures among adults at KNH in Nairobi, Kenya. Methodology This prospective study was conducted at Kenyatta National Hospital Department of radiology and the Plaza Imaging Solutions. Participants included patients sent to the Department of radiology to undergo ascending urethrography or micturating cystourethrography and presenting with clinical evidence of urethral strictures. Findings Two hundred adult male patients with clinically suspected urethral strictures were recruited between April and November 2012. The mean age was 45 years (SD ± 18.2). Out of the 200 patients 138 (69%) had a stricture (average size 2.9 cm ± 1.6). Most patients (52%) had pelvic fractures and 21% of patients had iatrogenic strictures following instrumentation or catheterization. Other causes infective causes (10%) or dysuria (17%). Seventy one (35.5%) strictures were located in the posteriorurethra while 36 (18%) were in the anterior and 31 (15.5%) spanned both the anterior and posterior urethra. Most (61.4%) strictures occur in single as compared to multiple (38.6%) sites. ix Conclusion and discussion Most urethral strictures in adult males in radiology units at Kenyatta and Plaza imaging are caused by iatrogenic trauma and accidental pelvic injuries. To avert cases of urethral strictures there is need to improve techniques for surgical intervention and clinical skills in managing urologic conditions in patients