title: Comprehensive analysis of etiology on the prognosis of urethral strictures.
abstract: BACKGROUND
  Urethral strictures remain a reconstructive dilemma, due to high incidence of recurrence and less than satisfactory outcomes. Even experienced surgeons following strict surgical principles have not achieved optimal results, leading us to think whether the etiology of strictures dictate the outcome . We evaluated this "cause-effect" relationship highlighting the significance of the etiology on the overall prognosis of urethral strictures.
  
  
  METHODS
  A total of 302 males with urethral strictures were assessed (both retrospectively and prospectively) over a period of ten years. The preoperative evaluation was performed by retrograde urethrogram, urethrosonogram, and uroflowmetry and categorized, based on etiology: a) as post traumatic, b) post infective, c) iatrogenic or d) unknown. Traumatic strictures were subjected to pelvic X-ray and sub-categorized into grades A, B and C, following the TILE classification. Patients were operated; with tunica albuginea urethroplasty for anterior strictures and U shape prostato-bulbar anastomosis for posterior strictures.
  
  
  RESULTS
  Traumatic strictures accounted for 54% of cases. 127 of the 302 patients were treated using Tunica Albuginea Urethroplasty, while U shaped Prostatobulbar Anastomosis was performed on others. Post traumatic strictures had best outcome whereas post infective strictures had the worse outcome. Among strictures following pelvic fractures, TILE grades A and B had a better post operative course as compared to TILE C. Overall complication rate was 13.24%.
  
  
  CONCLUSIONS
  Our study demonstrated that etiology of urethral strictures may play a vital role for the overall prognosis of urethral strictures.
authors.affiliation: Department of Surgery, M.G.M Medical College & M.Y.H group of Hospitals, Indore, Madhya Pradesh, India. rkmmyh70@yahoo.com
authors.forename: Rajkumar
authors.initials: R
authors.lastname: Mathur
authors.forename: Gaurav
authors.initials: G
authors.lastname: Aggarwal
authors.forename: Bhaskar
authors.initials: B
authors.lastname: Satsangi
authors.forename: Fareed
authors.initials: F
authors.lastname: Khan
authors.forename: Sudarshan
authors.initials: S
authors.lastname: Odiya
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D050723:Fractures, Bone / Q000150:complications; D006801:Humans; D008297:Male; D008875:Middle Aged; D010384:Pelvic Bones / Q000293:injuries; D011379:Prognosis; D016896:Treatment Outcome; D014525:Urethral Stricture / Q000209:etiology* / Q000628:therapy*; D014526:Urethritis / Q000150:complications; D014546:Urinary Catheterization / Q000379:methods; D055815:Young Adult