Changing trends in the aetiology and management of male urethral stricture disease: a survey from 13 centres in China
Lu-Jie Song1、Yue-Min Xu1、Kun-Jie Wang2、Jian Lin3、Guang Sun4、Zhong-Jin Yue5、Hai Jiang6、Yu-Xi Shan7、Shao-Xing Zhu8、Yu-Jie Wang9、Zhi-ming Liu10、Zhen-Hua Li11、Zhong-Hua Liu12、Qing-Ke Chen13、Min-Kai Xie1
1. Department of Urology, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, 200233, China；
2. Department of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, 610041, China；
3. Department of Urology, First Hospital of Peking University, Beijing, 100034, China；
4. Department of Urology, Second Hospital of Tianjin Medical University, Tianjin, 300211, China；
5. Department of Urology, Second Hospital of Lanzhou University, Lanzhou, Gansu Province, 730030, China；
6. Department of Urology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, 310003, China；
7. Department of Urology, The Second Affiliated Hospital, Soochow University, Suzhou, Jiangsu Province, 215004, China；
8. Department of Urology, The Affiliated Union Hospital, Fujian Medical University, Fuzhou, Fujian Province, 350001, China；
9. Department of Urology, The First Affiliated Hospital, Xinjiang University School of Medicine, Urumchi, Xinjiang Uygur Autonomous Region, 830054, China；
10. Department of Urology，The People's hospital of Qinghai Province, Xining, Qinhai Province, 817000, China；
11. Department of Urology, First Affiliated Hospital, China Medical University, Shenyang, Liaoning Province, 110001, China；
12. Department of Urology, The People's Hospital of Henan Province, Zhengzhou, Henan Province, 450003 China；
- Department of Urology, First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, 330006, China
Corresponding to: Lu-Jie Song, MD. PhD. Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, 600 Yishan Road, Shanghai 200233, China. Email: email@example.com ; Telephone: +86-21-64369181; Fax: +86-21-64701361
Purpose: To determine whether there were any changes in the aetiology and management of urethral strictures in China.
Patients and Methods: The data from 4764 male patients with urethral stricture disease who underwent treatment at 13 medical centres in China between 2005 and 2010 were retrospectively collected. The databases were analysed for the possible causes, site and treatment techniques for the urethral stricture, as well as for changes in the urethral stricture aetiology and management.
Results: The most common cause of urethral strictures was trauma, which occurred in 2466 patients (51.76%). The second most common cause was iatrogenic injures, which occurred in 1643 patients (34.49%). The most common techniques to treat urethral strictures were endourological surgery (1740, 36.52%), anastomotic urethroplasty (1498, 31.44%) and substitution urethroplasty (1039, 21.81%). A comparison between the first three years and the last three years showed that the constituent ratio of endourological surgery decreased from 54% to 32.75%, whereas the constituent ratios of anastomotic urethroplasty and substitution urethroplasty increased from 26.73% and 19.18% to 39.93% and 27.32%, respectively (P＜0.05).
Conclusions: During recent years, there has been an increase in the incidence of urethral strictures caused by trauma and iatrogenic injury. Endourological urethral surgery rates decreased significantly, and open urethroplasty rates increased significantly during the latter three years analysed.
Keywords: urethral stricture disease; aetiology; treatment; Chinese population