Management of Urethral Stricture Disease: A Clinical Outcome Study

Background: Urethral stricture disease is a common urological condition associated with significant morbidity and high recurrence rates despite multiple available treatment options. Selection of an appropriate management strategy is crucial for achieving durable clinical outcomes.

Objectives: To evaluate the clinical outcomes of different treatment modalities used in the management of urethral stricture disease and to identify factors associated with treatment success and recurrence.

Materials and Methods: This hospital-based observational study included 60 adult male patients diagnosed with urethral stricture disease at a tertiary care center. Patients were evaluated for stricture etiology, location, and length using clinical assessment and radiological investigations. Management included endoscopic procedures (visual internal urethrotomy or urethral dilatation) and open surgical reconstruction (urethroplasty). Patients were followed up clinically and with uroflowmetry, and treatment success was defined as satisfactory voiding without the need for repeat intervention.

Results: Trauma was the most common etiology (40%), followed by iatrogenic causes (30%). The bulbar urethra was the most frequently involved segment (53.3%). Endoscopic management showed moderate short-term success but higher recurrence rates, particularly in long-segment strictures. Urethroplasty demonstrated significantly higher success rates (>90%) with minimal recurrence. Stricture length was significantly associated with recurrence (p < 0.05).

Conclusion: Urethroplasty provides superior and durable outcomes compared to endoscopic management, especially in long-segment and recurrent urethral strictures. Early definitive surgical intervention based on stricture characteristics improves clinical outcomes and reduces recurrence.