One-stage urethroplasty for urethral strictures at the Ladoke Akintola University of Technology Teaching Hospital, Osogbo, South Western Nigeria

Background: Urethral stricture, a common urologic condition, is probably the most common cause of urinary retention in tropical Africa and a frequent cause of lower urinary tract symptoms worldwide. This study aimed at presenting our experience with one-stage urethroplasty at the Ladoke Akintola University of Technology Teaching Hospital Osogbo, Nigeria. Methods: All male patients who underwent one-stage urethroplasty between December 2005 and December 2011 were studied retrospectively. Details of their presentation and management were reviewed. Results: A total of 50 patients aged 2-75 years (mean ± SD 44.2 ± 21.53 years) with a urethral stricture underwent one-stage urethroplasty. The modal age group was 61-75 years (26 %). In all, 27 (54 %) patients were >40 years. Strictures following previous urethritis were more common (29, 58 %) than those seen after trauma (21, 42 %). Strictures following trauma were more common in men ≤40 years (52.2 %), and 69 % of strictures in men >40 years were infective in origin. Altogether, 88 % of strictures were exclusively found in the anterior urethra. In all, 32 (64 %) patients had bacteriuria at presentation. Strictures ≥2 cm with extensive fibrosis were noted in 21 (42 %). Excision of scar tissue was done, followed by end-to-end anastomosis in 32 (64 %), penile pedicle flap in 16 (32 %), and buccal mucosal graft in 2 (4 %) of the patients. Wound infection was the most common complication. Overall, 76 % of patients achieved a urine flow rate of 15 ml/s and postvoid residual urine of ≤50 ml. Conclusions: One-stage urethroplasty offered satisfactory results in the study group. It is recommended for urethral reconstruction in men with urethral stricture. © 2013 Société Internationale de Chirurgie.