Men with Anterior Urethral Strictures are Often Treated without Imaging or Discussion of all Treatment Options.

ABSTRACT

INTRODUCTION: We determined how men presenting to our institution with anterior urethral strictures and recurrent strictures after treatment were evaluated, counseled and treated. METHODS: A prospective study was performed of all patients presenting to our institution with recurrent anterior urethral stricture disease between 2011 and 2014. Outside records were reviewed and all patients were queried to determine if they had any urethral imaging before treatment, what treatment was given and what other options were discussed. Patients were excluded from the study if they had a history of hypospadias, or if they were initially treated more than 10 years ago or treated outside of the United States. RESULTS: A total of 100 men were included in the study, of whom 89 (89%) had prior treatment with urethral dilation or endoscopic incision. Of these patients 81 (91%) were treated without prior urethral imaging. Of the 90 patients who were treated or advised to have treatment with direct visual internal urethrotomy or dilation, 81 (90%) were not offered urethroplasty as an option. There were 66 patients who had multiple such treatments and of this group only 6 (9%) were offered urethroplasty before subsequent treatment. CONCLUSIONS: In this study the majority of men with urethral strictures were treated without urethral imaging. Furthermore, most men were not offered urethroplasty as an option before undergoing 1 or more urethral dilations or internal urethrotomies.