Gul A, Ekici O, Zengin S, Barali D, Keskin T. Investigation of risk factors in the development of recurrent urethral stricture after internal urethrotomy. World J Clin Cases 2024; 12(14): 2324-2331 [PMID: 38765734 DOI: 10.12998/wjcc.v12.i14.2324]
Corresponding Author of This Article
Abdullah Gul, MD, Associate Professor, Researcher, Department of Urology, University of Health Sciences, Bursa Yüksek İhtisas Education and Research Hospital, Mimar Sinan Mah. Emniyet Cad. Yıldırım, Bursa 16310, Türkiye. dr_abdullahgul@hotmail.com
Research Domain of This Article
Urology & Nephrology
Article-Type of This Article
Retrospective Cohort Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. May 16, 2024; 12(14): 2324-2331 Published online May 16, 2024. doi: 10.12998/wjcc.v12.i14.2324
Investigation of risk factors in the development of recurrent urethral stricture after internal urethrotomy
Abdullah Gul, Ozgur Ekici, Salim Zengin, Deniz Barali, Tarik Keskin
Abdullah Gul, Salim Zengin, Deniz Barali, Tarik Keskin, Department of Urology, University of Health Sciences, Bursa Yüksek İhtisas Education and Research Hospital, Bursa 16100, Türkiye
Ozgur Ekici, Department of Urology, University of Health Sciences, Bursa City Hospital, Bursa 16000, Türkiye
Author contributions: Gul A, Ekici O, Zengin S, Barali D, Keskin T contributed equally to this work; Ekici O and Gul A designed the research study; Zengin S and Barali D performed the research; Keskin T and Gul A contributed new reagents and analytic tools; Ekici O, Gul A, Zengin S and Barali D analyzed the data and wrote the manuscript; All authors have read and approve the final manuscript.
Institutional review board statement: The study was reviewed and approved by the University of Health Sciences Bursa Yuksek İhtisas Education and Research Hospital Institutional Review Board, No. 2011-KAEK-25/11-17.
Informed consent statement: All study participants or their legal guardian provided informed written consent about personal and medical data collection prior to study enrolment.
Conflict-of-interest statement: The authors state that they have no conflict of interest.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Abdullah Gul, MD, Associate Professor, Researcher, Department of Urology, University of Health Sciences, Bursa Yüksek İhtisas Education and Research Hospital, Mimar Sinan Mah. Emniyet Cad. Yıldırım, Bursa 16310, Türkiye. dr_abdullahgul@hotmail.com
Received: January 8, 2024 Revised: February 8, 2024 Accepted: April 1, 2024 Published online: May 16, 2024 Processing time: 115 Days and 14.9 Hours
Abstract
BACKGROUND
Urethral stricture is a condition that often develops with trauma and results in narrowing of the urethral lumen. Although endoscopic methods are mostly used in its treatment, it has high recurrence rates. Therefore, open urethroplasty is recommended after unsuccessful endoscopic treatments.
AIM
To investigate the risk factors associated with urethral stricture recurrence.
METHODS
The data of male patients who underwent internal urethrotomy for urethral stricture between January 2017 and January 2023 were retrospectively analyzed. Demographic data, comorbidities, preoperative haemogram, and biochemical values obtained from peripheral blood and operative data were recorded. Patients were divided into two groups in terms of recurrence development; recurrence and non-recurrence. Initially recorded data were compared between the two groups.
RESULTS
A total of 303 patients were included in the study. The mean age of the patients was 66.6 ± 13.6 years. The mean duration of recurrence development was 9.63 ± 9.84 (min-max: 1-39) months in the recurrence group. Recurrence did not occur in non-recurrence group throughout the follow-up period with an average time of 44.15 ± 24.07 (min-max: 12-84) months. In the comparison of both groups, the presence of diabetes mellitus (DM), hypertension (HT), and multiple comorbidities were significantly higher in the recurrence (+) group (P = 0.038, P = 0.012, P = 0.013). Blood group, postoperative use of non-steroidal anti-inflammatory drugs, preoperative cystostomy, cause of stricture, iatrogenic cause of stricture, location and length of stricture, indwelling urinary cathater size and day of catheter removal did not differ between the two groups. No statistically significant difference was observed between the two groups in terms of age, uroflowmetric maximum flow rate value, hemogram parameters, aspartate aminotransferase (AST), alanine aminotransferase (ALT), fasting blood sugar, creatinine, glomerular filtration rate, neutrophil-lymphocyte ratio, platelet-lymphocyte ratio, lymphocyte-monocyte ratio, monocyte-lymphocyte ratio and AST/ALT ratios.
CONCLUSION
In patients with urethral stricture recurrence, only the frequency of DM and HT was high, while inflammation marker levels and stricture-related parameters were similar between the groups.
Core Tip: In our study, we aimed to investigate whether there are inflammation markers in peripheral blood that can predict urethral stricture recurrence after internal urethrotomy and whether other etiological factors have a place in predicting stricture recurrence. According to our results, no inflammation marker was found to predict urethral stricture recurrence. The possibility of recurrence in patients with comorbidities such as diabetes mellitus and hypertension should be taken into consideration and the patient should be informed that more curative methods may be needed.
