TITLE:
Epidemiologic, Clinical and Radiological Aspects of Male Urethral Strictures at the Ngaoundéré Regional Hospital
AUTHORS:
Mathurin Neossi Guena, Florent Zilbinkai Alapha, Eric Lonang Wandji, Odile Fernande Zeh, Joseph Gonsu Fotsing
KEYWORDS:
Stenosis, Urethrocystography, Male Urethra
JOURNAL NAME:
Open Journal of Radiology,
Vol.9 No.2,
June
4,
2019
ABSTRACT: Background: Urethral stricture is a disabling condition that remains prevalent due to the upsurge of sexually transmitted infections and traumatic lesions of the urethra during trauma of the pelvis in humans. Objective: Describe the epidemiological, clinical and radiological presentations of male urethral strictures. Method: It was a cross-sectional and descriptive study during a one-year period from January to December 2017 including all male patients presenting for a urethrocystography examination, at the Ngaoundere Radiology and Medical Imaging Center who agreed to participate. The urethrocystography technique depended on patient’s condition and was either retrograde, anterograde, or following intravenous urography. The examinations were performed with GE X-ray equipment using Kodak Dry View CRs. The interpretation was performed by a radiologist with at least five years of experience. The variables studied were age, clinic, history, uretrocystography technique and results. The data were collected using a previously established data sheet and processed with Sphinx Plus2 V5 and Microsoft Excel 2010 software. Results: 39 patients were enrolled in this study; the average age of our patients was 43.8 years with extremes of 4 and 76 years. The 50 - 60 age group (30.7%) was the most affected. Infection (53.9%) and trauma (23.1%) were the most common etiologies; dysuria (38.5%) and diminution of urinary flow (30.8%) were the most patient’s complaint. Retrograde urethrocystography (66.7%) was the most performed technic. Minimal bleeding in 46.2% of patients was the most common incident during urethrocystography; 76.9% of patients had a difficult urination and 7.7% an impassable urethral meatus. After interpretation, 84.6% of patients had urethral stenosis, which was associated with bladder diverticula (23%) and fistulas (15.3%). The stenosis was seated on membranous urethra (81.8%), tight type (45.4%), short (66.7%) and single (81.8%). The post-void residue was significant in 84.6% of cases and not significant in 15.4% of cases. 15.3% of the urethrocystographies were normal. Conclusion: Urethral stenosis in Ngaoundere mainly affects young adult; the main etiology is infectious, very often unique, short, and tight and the membranous urethra is the seat of predilection. Hence, to reduce the extent of pathology with its functional consequences and its impact on the socio-professional life in our context, the focus should be on sexually transmitted infectious.