July 2026, Volume 4, Issue 7

Author

Ashok Kumar R, Sanjeev Kumar S and Senthilnathan K

Abstract

Background: Urethral stricture disease is a common urological condition characterized by fibrosis of the urethral epithelium and corpus spongiosum, leading to narrowing of the urethral lumen and bladder outlet obstruction. Optical Internal Urethrotomy (OIU) is widely used for the management of short-segment bulbar urethral strictures because of its simplicity, safety, and minimal invasiveness. However, recurrence following OIU remains a major challenge. Several factors have been studied as predictors of recurrence, but the role of percentage luminal narrowing on Retrograde Urethrogram (RGU) has not been extensively evaluated. Methodology: A prospective observational study was conducted in the Department of Urology, Government Stanley Medical College and Hospital, Chennai, from September 2012 to March 2014. Fifty-one patients were initially evaluated, of whom 37 patients with primary bulbar urethral strictures less than 2 cm in length fulfilled the inclusion criteria and completed follow-up. Patients with previous urethral interventions, complete urethral obliteration, or strictures greater than 2 cm were excluded. Percentage luminal narrowing was calculated from preoperative Retrograde Urethrogram measurements. Results: The study included 37 patients, with the majority belonging to the 31-40 years age group (32%). Idiopathic stricture was the most common etiology (41%), followed by traumatic (27%), iatrogenic (19%), and lichen sclerosus-related strictures (13%). Eleven patients (29.7%) achieved successful outcomes, whereas 26 patients (70.3%) experienced recurrence. All patients with luminal narrowing between 40% and 60% had successful outcomes. Among patients with luminal narrowing greater than 60%, 25 out of 28 experienced recurrence. Most recurrences occurred within the first 10 months following surgery. A statistically significant association was observed between percentage luminal narrowing and treatment outcome (p < 0.001).