The aim is to highlight the epidemiological, clinical and therapeutic aspects of iatrogenic urethral strictures. Methodology: This was a retrospective study, descriptive type, 6 years from January 1st 2012, to December 31st 2017 carried out in the Urology-Andrology department of the National Hospital Ignace Deen of Conakry. All records of patients carrying the Diagnosis of iatrogenic urethral stricture were included in this study. Results: We collected 30 cases of iatrogenic urethral stricture, with a frequency of 2.5%. The average age of the patients was 62.33 years. The most affected age group is from 71 to 80 years (33.33%). Dysuria was the main reason for consultation. Retrograde urethrocystography plus voiding cystourethrography (RUC-VCU) allowed us to make the diagnosis. The treatment was essentially surgical and several techniques were used. Endoscopic internal urethrotomy alone was the most performed surgical technique, followed by segmental uretrectomy associated with end-to-end urethrography. Conclusion: Iatrogenic urethral stricture is easy to diagnose but difficult to manage due to the frequency of recurrences. Improving the quality of care, in particular urethral catheterizations and transurethral endoscopic maneuvers, makes it possible to prevent it.
References
[1]
Ngaroua, N.J.E., Djibrilla, Y., Asmaou, O., Mbo, A.J., et al. (2017) Epidemiological, Clinical and Management of Urethral Stricture in Adults in a District Hospital in N’Gaoundéré, Cameroon. Pan Africa Medical Journal, 26, Article No. 193. https://doi.org/10.11604/pamj.2017.26.193.9669
[2]
Boccon-Gibod, L. (2002) Rétrécissements de l’urétre. Encycl Med Chir (Editions scientifiques et médicales Elsevier SAS, Paris, tous droits réservés). Néphrologie-Urologie, 18-370-A-10, 6 p.
[3]
Ondo, C.Z., Fall, B., Diallo, Y., Sow, Y., Sarr, A., Ngonga, R., et al. (2015) Iatrogenic Strictures of the Urethra: Experience of a Hospital Senegalese. African Journal of Urology, 21, 144-147. https://doi.org/10.1016/j.afju.2015.03.003
[4]
Rouanet, A., Gagnat, A., et al. (2011) Efficacy and Tolerance of Self-Catheter Dilatation after Internal Urethrotomy for Urethral Strictures. Advances in Urology, 21, 955-960.
[5]
Hounnasso, P.P., Toresanni, R., Avakodjo, J.D.G., et al. (2015) Epidemiological and Diagnostic Aspects of Male Urethral Stricture at the Hubert Koudougou Maga National Hospital and University Center in Cotonou. Uro’andro, 1, 162-165.
[6]
Kabore, F.A., zango, B., KParé, A., Kirakoya, B., Kambou, T., Ouattara, A., et al. (2015) Retrospective Analysis of the Surgical Treatment of a Series of 148 Cases of Male Urethral Stricture in Burkina Faso. Uro’andro, 1, 200-204.
[7]
Guirassy, S., Simakan, N.F., et al. (2001) Post-Traumatic Stricture of the Urethra in the Urology Department of the CHU Ignace Deen Apropos of 77 Cases Annales d’Urologie, 35, 162-166. https://doi.org/10.1016/S0003-4401(01)00021-3
[8]
Dje, K., Coulibaly, A. and Coulibaly, N. (2009) Endoscopic Internal Urethrotomy in the Treatment of acquired Urethral Stricture in Black Africans: About 140 Cases. Black African Medicine, 46, 56-61.
[9]
Tengue, K., Kpatcha, T.M. and Leloua, E. (2014) Stenosis of the Male Urethra: Epidemiological, Diagnostic, Therapeutic and Evolutionary Aspects at the CHU Sylvanus Olympio in Togo. Journal de la Recherche Scientifique de l’Université de Lomé, 16, 399-340.
[10]
Mugalo, E.L., Bwombwongo, S.O. and Ayuo, P.O. (2013) Aetiology of Urethral Strictures at Moi Teaching and Refferal Hospital. The Annals of African Surgery, 10, 11-14.
[11]
Boccon-Gibod, L. and Aboulker, P. (2002) Tactics and Operative Techniques in Male Urethral Strictures. Encycl Med Chir (Scientific and Medical Editions) Elsevier SAS Paris, Nephrology-Urology, 18-30.
[12]
Boujnah, H., M’Hiri Mosbah, A., Zmerli, S. and Coll. (2015) Iatrogenic Strictures of the Urethra. The Journal of Urology, No. 2, 163-166.
[13]
Lückhoff, C., Mitra, B., Cameron, P.A., Fitzgerald, M. and Royce, P. (2011) The Diagnosis of Acute Urethral Trauma. Injury, 42, 913-991. https://doi.org/10.1016/j.injury.2010.08.007
[14]
Tritschler, S., Roosen, A., Füllhase, C., Stief, C.G. and Rübben, H. (2013) Urethral Stricture: Etiology, Investigation and Treatments. Deutsches Ärzteblatt International, 110, 220-226. https://doi.org/10.3238/arztebl.2013.0220
[15]
Lumen, N., Hoebeke, P., Willemsen, P., De Troyer, B., Pieters, R. and Oosterlinck, W. (2009) Etiology of Urethral Stricture Disease in the 21st Century. The Journal of Urology, 182, 983-987. https://doi.org/10.1016/j.juro.2009.05.023
[16]
Benjelloun, M., Drissi, M., Makhloufi, M., Nouri, A., Karmouni, T., Tazi, K., et al. (2008) Treatment of Urethral Strictures by Endoscopic Internal Urethrotomy: Anatomical and Functional Results of a Series of 244 Cases. African Journal of Urology, 14, 114-119. https://doi.org/10.1007/s12301-008-0002-3
[17]
Renard, J., Sao-Nam, T. and Iselin, C.E. (2012) Transurethral Catheterization in the Male Subject: Prevention and Treatment of Iatrogeny. Revolution Medicines Switzerland, 8, 2318-2323.
[18]
Alken, C.E. and Sokeland, J. (2014) Urethral Stricture. Abstract of Uro, 285 p.
[19]
Raibaut, P., Terrier, A., Jacq, C., Hubeaux, K., Ismaël, S.S. and Amarenco, G. (2008) Interest of Self-Catheterization in Case of Urinary Retention. Progrès en Urologie, 18, 29-34. https://doi.org/10.1016/S1761-676X(08)70016-6
[20]
Kashefi, C., Messer, K., Barden, R., Sexton, C. and Parsons, J.K. (2008) Incidence and Prevention of Iatrogenic Urethral Injuries. The Journal of Urology, 179, 2254-2258. https://doi.org/10.1016/j.juro.2008.01.108
[21]
Thomas, A.Z., Giri, S.K., Meagher, D. and Creagh, T. (2009) Avoidable Iatrogenic Complications of Urethral Catheterization and Inadequate Intern Training in a Tertiary Care Teaching Hospital. BJU International, 104, 1109-1112. https://doi.org/10.1111/j.1464-410X.2009.08494.x
[22]
Manalo Jr., M., Lapitan, M.C.M. and Buckley, B.S. (2011) Medical Interns’ Knowledge and Training Regarding Urethral Catheter Insertion and Insertion-Related Urethral Injury in Male Patients. BMC Medical Education, 11, Article No. 73. https://doi.org/10.1186/1472-6920-11-73
[23]
Ouattara, Z., Tembely, A., Sanogo, Z.Z., Doumbia, D., Cisse, C.M.C. and Coll. (2004) Narrowing of the Urethra in Men at the Urology Department of Point \"G\" Hospital, Mali Médical, T XIX N° 3 & 4.
[24]
Barnaud, P., Mensah, A., Merrien, Y. and Perquis, T. (2008) Monsieur’s Urethroplasty in Urethral Strictures: About 26 Patients. Afrique Medicale, 17, 189-191.
[25]
Morehouse, D., Belitsky, P. and Mac Kinnon, K. (1972) Rupture of the Post-Urethral. Journal of Urology, 107, 255-258.
[26]
Sikpa, K.H., Kpatcha, T.M., et al. (2016) Urethroplasty by Resection End-to-End Anastomosis for Narrowing of the Male Urethra; At the CHU Sylvanus OLYMPIO in Lomé, TOGO. Afju, 22, No. 4.
[27]
Kamoune, N., Doui Doumgba, A., Khaltan, E., Mamadou, N.N., et al. (2014) Stenosis of the Male Urethra in Bangui (CAR): Epidemiological Approach from 69 Files Collected in the Urology Department of the Amitié Hospital. Médecine d’Frique Noire électronique, 53, 645-650.
[28]
Mhiri, C.H., Mhiri, M.N. and Smid, A.I. (2012) Urethral Strictures. About 158 Cases. Tunisia Med, 70, 513-519.
[29]
Giannakopoulos, X. and Kammenos, A. (2002) Treatment of Male Urethral Strictures by Internal Urethrotomy. The Journal of Urology, 98, 203-205.
[30]
Santucci, R.A., Mario, L.A. and Mc Annich, J.W. (2002) Anastomotic Urethro-Plasty for Bulbar Urethral Stricture: Analysis of 168 Patients. The Journal of Urology, 167, 1715-1719. https://doi.org/10.1016/S0022-5347(05)65184-1
[31]
Leremboube, H., John, F., Bladou, F., Gabriel, H., Vaillant, J.L. and Coulange, C. (2001) Long-Term Results of Strictures of the Male Urethra. Annales d’Urologie, 24, 76-77.
