Etiology of male urethral strictures-Evaluation of temporal changes at a single center,and review of the literature

ObjectiveTo evaluate temporal changes in male urethral stricture etiology and socio-demographic features by comparing a contemporary with a previously studied cohort.Patients and methodsA total of 125 men with proven urethral strictures were interviewed April 2007 through March 2008 using a structured questionnaire on demographic, socio-economic and clinical aspects. The findings were compared with those reported in 120 urethral stricture patients seen at the same institution during 1991. Statistical analysis was performed using analysis of variance (ANOVA) and Fisher's exact tests (p < 0.05 = statistically significant). The protocol was approved by the local ethics committee.ResultsCompared to the 1991 cohort, the current cohort had a significantly greater proportion with >6 years of schooling (77.5% vs 45.8%), mean number of sex partners (7.3 vs 4.6) and illegal drug use (20.8% vs 10%). Stricture etiology showed a decrease in urethritis (25.6% vs 45%) and external trauma (16.8% vs 28.3%) and an increase in internal (iatrogenic) trauma (36.8% vs 10%). The groups with urethritis and external trauma were significantly younger (mean age 46.1 and 36.3 years) than those with iatrogenic trauma or idiopathic etiology (55.5 and 53.8 years, respectively). Urethritis etiology was associated with a greater number of sex partners, lower education level, previous imprisonment, and illegal drug use.ConclusionsOver the past 15 years there was an increase in education levels, illegal drug usage and number of sex partners in men with urethral strictures. There was a decrease in urethritis and external trauma, and an increase in iatrogenic trauma as stricture etiology.