RISK FACTORS OF URETHRAL STRICTURE: A SYSTEMATIC REVIEW
DOI:
https://doi.org/10.61841/yh8tcx94Keywords:
Risk factor, Predicting factor, Urethral strictureAbstract
Background: Urethral stricture in males is a narrowing of the anterior urethra caused by fibrosis and cicatrisation of the urethral mucosa and adjacent spongiosus tissue ("spongiofibrosis"). In the male posterior urethra, there is no spongiosus tissue; therefore, stenosis is the preferred term. Understanding the risk factors of urethral strictures may be amenable to preventive measures resulting in a decrease in disease severity and health care expenditure.
Aim: This study aims to summarize and assess the risk factors of urethral stricture through a comprehensive systematic review.
Methods: A systematic search strategy was conducted across several electronic reference databases (PubMed, Cochrane Library, Google Scholar) and included articles published between 2013–2023. Duplicate publications, review articles, and incomplete articles were excluded.
Results: The databases search identified a total of 16.645 articles (Table 1) and resulted in 16.155 articles after duplicates removed. Of these, 15.955 articles were excluded due to non-original study and titles and abstract not represented the focus of interest; and resulting in 200 articles for screening process. Articles not evaluating the focus of interest and articles in which full-text are not available are excluded, resulting in 15 articles for eligibility criteria. Among them, 10 articles did not give sufficient details about the risk factors of urethral stricture and some did nit differenriate clearly between the risk factors of urethral stricture and recurrence of urethral stricture. Hence, we found 5 appropriate studies included.
Conclusion: The risk factors of urethral stricture in this study includes the dose of brachyterapy for prostate cancer patients, lower resection speed of BPH, prolonged operative time, intraoperative urethral mucosa rupture, post-operative continuous infection, the diameter of the instrument, presence of chronic prostatitis in anamnesis, increased volume of the prostate, repeated drainage of the bladder using the urethral catheter, high comorbidity burden, second TURP surgery, history of preoperative catheter insertion, high postoperative WBC, and long postoperative catheterization time.
References
Lumen N, Campos-Juanatey F, Dimitropoulos K, Greenwell T, Martins FE, Osman N, et al. European Association of Urology Guidelines on Urethral Strictures. Eur Assoc Urol. 2023;
Palminteri E, Berdondini E, Verze P, De Nunzio C, Vitarelli A, Carmignani L. Contemporary urethral stricture characteristics in the developed world. Urology. 2013;81(1).
Alwaal A, Blaschko SD, McAninch JW, Breyer BN. Epidemiology of urethral strictures. Vol. 3, Translational Andrology and Urology. 2014.
Stein DM, Thum DJ, Barbagli G, Kulkarni S, Sansalone S, Pardeshi A, et al. A geographic analysis of male urethral stricture aetiology and location. BJU Int. 2013;112(6).
Wessells H, Angermeier KW, Elliott S, Gonzalez CM, Kodama R, Peterson AC, et al. Male Urethral Stricture: American Urological Association Guideline. J Urol [Internet]. 2017;197(1):182–90. Available from: http://dx.doi.org/10.1016/j.juro.2016.07.087
Dielubanza EJ, Han JS, Gonzalez CM. Distal urethroplasty for fossa navicularis and meatal strictures. Vol. 3, Translational Andrology and Urology. 2014.
Daneshvar M, Hughes M, Nikolavsky D. Surgical Management of Fossa Navicularis and Distal Urethral Strictures. Vol. 19, Current Urology Reports. 2018.
Moltzahn F, Pra AD, Furrer M, Thalmann G, Spahn M. Urethral strictures after radiation therapy for prostate cancer. Vol. 57, Investigative and Clinical Urology. 2016.
Cornu JN, Ahyai S, Bachmann A, De La Rosette J, Gilling P, Gratzke C, et al. A systematic review and meta-analysis of functional outcomes and complications following transurethral procedures for lower urinary tract symptoms resulting from benign prostatic obstruction: An update. Vol. 67, European Urology. 2015.
Fenton AS, Morey AF, Aviles R, Garcia CR. Anterior urethral strictures: Etiology and characteristics. Urology. 2005;65(6).
Michielsen DPJ, Coomans D. Urethral strictures and bipolar transurethral resection in saline of the prostate: Fact or fiction? J Endourol. 2010;24(8).
Rassweiler J, Teber D, Kuntz R, Hofmann R. Complications of Transurethral Resection of the Prostate (TURP)-Incidence, Management, and Prevention. Vol. 50, European Urology. 2006.
Chen ML, Correa AF, Santucci RA. Urethral Strictures and Stenoses Caused by Prostate Therapy. Rev Urol. 2016;18(2).
Lumen N, Oosterlinck W. Challenging non-traumatic posterior urethral strictures treated with urethroplasty: A preliminary report. Int Braz J Urol. 2009;35(4).
Hindson BR, Millar JL, Matheson B. Urethral strictures following high-dose-rate brachytherapy for prostate cancer: Analysis of risk factors. Brachytherapy [Internet]. 2013;12(1):50–5. Available from: http://dx.doi.org/10.1016/j.brachy.2012.03.004
Tao H, Jiang YY, Jun Q, Ding X, Jian DL, Jie D, et al. Analysis of risk factors leading to postoperative urethral stricture and bladder neck contracture following transurethral resection of prostate. Int Braz J Urol. 2016;42(2):302–11.
Grechenkov A, Sukhanov R, Bezrukov E, Butnaru D, Barbagli G, Vasyutin I, et al. Risk factors for urethral stricture and/or bladder neck contracture after monopolar transurethral resection of the prostate for benign prostatic hyperplasia. Urologia. 2018;85(4):150–7.
Afandiyev F, Ugurlu O. Factors predicting the development of urethral stricture after bipolar transurethral resection of the prostate. Rev Assoc Med Bras. 2022;68(1):50–5.
Elliott SP, Meng M V., Elkin EP, McAninch JW, Duchane J, Carroll PR. Incidence of Urethral Stricture After Primary Treatment for Prostate Cancer: Data From CaPSURE. J Urol. 2007;178(2).
Mohammed N, Kestin L, Ghilezan M, Krauss D, Vicini F, Brabbins D, et al. Comparison of acute and late toxicities for three modern high-dose radiation treatment techniques for localized prostate cancer. Int J Radiat Oncol Biol Phys. 2012;82(1).
Tugcu V, Tasci AI, Sahin S, Zorluoglu F. Comparison of photoselective vaporization of the prostate and transurethral resection of the prostate: A prospective nonrandomized bicenter trial with 2-year follow-up. J Endourol. 2008;22(7).
Gilling PJ, Wilson LC, King CJ, Westenberg AM, Frampton CM, Fraundorfer MR. Long-term results of a randomized trial comparing holmium laser enucleation of the prostate and transurethral resection of the prostate: Results at 7 years. BJU Int. 2012;109(3).
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