#0877

A Profile of Post-Infectious and Post-Inflammatory Urethral Strictures in the Philippines from 2021-2024

J. Timkang¹, R. Andutan², M. Abalajon³

¹University of Santo Tomas Hospital, Department of Surgery, Manila i, Philippines
²Maria Reyna Xavier University Hospital, Department of Urology, Cagayan De Oro City, Philippines
³East Avenue Medical Center, Department of Urology, Quezon City, Philippines

Introduction:

Urethral strictures are a common urological condition that can result from infections, trauma, or iatrogenic injury. In developing countries like the Philippines, infections such as gonorrhea, genitourinary tuberculosis (GUTB) and lichen sclerosus (LS) or balanitis xerotica obliterans (BXO) remain significant causes, but local data is limited. This study aims to address the gap by profiling patients with post-infectious and post-inflammatory urethral strictures. To describe the clinical and demographic profile of patients with urethral strictures secondary to gonococcal infections, GUTB, or lichen sclerosis (LS/BXO) in terms of age, comorbidities, previous surgical interventions, stricture length, location, and type.

Material and methods:

A retrospective descriptive study was conducted using records from 2 high-volume reconstructive urologists in Metro Manila and Cagayan de Oro City from 2021 to 2024. 97 out of 655 cases were reviewed for variables including etiology, stricture characteristics, and patient comorbidities

Results:

Gonorrhea was the leading cause of infection-related urethral strictures (63.92%), followed by GUTB (24.74%) and LS/BXO (11.34%). Hypertension and diabetes were common comorbidities. Previous urologic procedures varied: for Gonorrhea, 23 had STC, 19 DVIU, 2 urethroplasty, 3 dilatations, and 15 had no intervention. For GUTB, 12 had STC, 6 DVIU, 1 urethroplasty, 2 dilatations, 1 cystoscopy, and 3 had no intervention. For LS/BXO, 9 had STC, 5 dilatations, and 1 had no intervention. Stricture lengths were L1 (<2 cm) in 31.96%, L2 (2-7 cm) in 49.48%, and L3 (>7 cm) in 18.56%. Among Gonorrhea cases, 37.10% were L1, 45.16% L2, and 17.74% L3. In GUTB, 16% were L1, 64% L2, and 20% L3. In LS/BXO, 36.36% were L1, 45.45% L2, and 18.18% L3. Stricture location per LSE classification: Among 97 patients, 47 (48.45%) had S1 (bulbar urethra) strictures, 35 (36.08%) had S2 (penile urethra) strictures, and 17 (17.53%) had S3 (pan-urethral) strictures. In Gonorrhea cases, most had S1a (53.97%), followed by S3 (11.11%). GUTB cases were more evenly distributed, with 28% at S3. LS/BXO cases were predominantly at S2d (27.27%) and S3 (27.27%). Most strictures were partially obliterated (88.66%), with complete obliteration in 11.34%. Single strictures were more common (89.69%) than multiple (10.31%).