Analysis of recurrent urethral strictures due to iatrogenic urethral trauma

Background/aim: We aimed to analyze the effects of stricture location, etiology, age, and catheterization time on recurrence rate and recurrence time in patients who underwent direct vision internal urethrotomy (DVIU) for urethral strictures. Materials and methods: Patients were divided into three groups according to the location of the stricture: penile urethra, membranous urethra, and prostatic urethra strictures. Patients were also divided into three groups according to etiologic factors: strictures secondary to endoscopic procedures, urethral catheterization, and open or radical prostatectomy (anastomotic strictures were included in this group). Patients were also divided into three groups according to catheterization time: <2, 2-5, and >5-7 days. Recurrence rate and time data were analyzed according to stricture location, etiology, age, and catheterization time.
Results: The recurrence rate was significantly higher in endoscopic procedures. Recurrence rate was significantly lower and recurrence time was significantly earlier in penile urethral strictures. Recurrence rate was significantly lower and recurrence time was significantly longer in short catheterized group than in the other two groups. However, first recurrence time was not different between the groups, while second and multiple recurrence times were significantly earlier in patients <60 years old.
Conclusion: Patients are exposed to multiple operations as a result of frequently recurring urethral strictures. Although DVIU is an important first-line treatment method for strictures, alternative methods should be considered for frequently recurring cases.