Demographics, Clinical Presentation, Management and Outcome of Patients with Urethral Stricture in Qassim Region

Background: Urethral stricture (UrS), a narrowing of the urethra, is caused by many etiologies and can vary in severity. This condition can lead to various urinary symptoms and complications, resulting in emergency room visits and hospital admissions. This study aimed to assess the demographics, clinical characteristics, management, and outcomes of people with urethral stricture in the Qassim Region of Saudi Arabia. Methods and Results: This retrospective study included all cases of urethral stricture treated at King Fahd Specialist Hospital (KFSH), Buraydah, Saudi Arabia, between October 2017 and July 2024. The complete records of 90 UrS patients of all ages were analyzed. The study recorded the age, clinical characteristics, management, and outcomes of UrS patients. All patients were male. The mean age of the patients was 41.13±16.61 years, with 55.6% under 41. In most of the cases (95.6%), urethral strictures were symptomatic, commonly presenting lower urinary tract symptoms (LUTS) (87.2%), followed by urinary tract infection (UTI) (3.4%), acute urine retention (2.3%), and dysuria (2.3%). Regarding the cause, most cases were found to be idiopathic (81.1%), followed by post-infectious causes (6.7%) and traumatic causes (5.6%). Iatrogenic causes were identified in only two patients (2.2%), as well as urethral stones in 2(2.2%) patients. Most strictures occurred in the bulbomembranous region of the urethra (83.5%). Regarding treatment modalities, visual internal urethrotomy was done for 82(91.2%) patients and follow-up for 3(3.3%) patients. In most cases, 64.4% of strictures were successfully treated, while the strictures recurred in 35.6% of patients. Conclusion: Urethral stricture disease was common among males under 41 who presented with LUTS and UTI to King Fahd Specialized Hospital. Most of the cases were idiopathic, followed by post-infectious causes and traumatic causes, and most of the strictures occurred in the bulbomembranous urethra. Visual internal urethrotomy is commonly used for both visualization and treatment of urethral stricture. The study highlights the importance of using modern technology to facilitate a comprehensive and systematic approach to understanding the underlying pathology of urethral stricture. It is particularly important to rule out other potential causes, especially when there was no apparent cause initially.