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September 10, 2025

Outcomes and predictive factors of recurrence after endoscopic management of male bulbar urethral stricture at a Tertiary Care Centre

Key Points

The study found an overall stricture-free rate of 80.3% at 12 months following urethrotomy procedures.
First visual internal urethrotomy led to a 59.7% stricture-free rate, decreasing to 45.5% after the second procedure.
Stricture length and presence of spongiofibrosis notably influenced recurrence rates in patients undergoing urethrotomy.
Predictive factors for treatment failure included older age, obesity, and the health of the urethral mucosa, indicating important criteria for selection.

Abstract

Introduction: Male urethral stricture is a common clinical condition in urology with significant socioeconomic impacts and is associated with high recurrence rates.Visual internal urethrotomy (VIU) is a widely used endoscopic treatment for short-segment urethral strictures (2 cm, p = 0.045), health of the urethral mucosa (healthy vs unhealthy, p = 0.250), presence of spongiofibrosis (present vs absent, p = 0.07), and stricture location (mid-bulbar urethral stricture in 74 patients 56.09%, penobulbar/distal bulbar urethral stricture in 50 patients 37.8%, and bulbomembranous/proximal bulbar urethral stricture in eight patients 6.09%). Conclusions: Although VIU is a relatively simple procedure, it yields acceptable outcomes in carefully selected patients. Stricture length and the presence of spongiofibrosis had a statistically significant impact on outcomes. Other independent predictive factors for failure of VIU included older age, obesity, and mucosal health.

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