Department of Urology, The Second Xiangya Hospital, Central South University, Changsha, China.
Department of Nephrology, Renmin Hospital of Wuhan University, Wuhan, China.
Front Public Health. 2021 Dec 24;9:794451. doi: 10.3389/fpubh.2021.794451. eCollection 2021.
Male urethral stricture is a disease with a high incidence rate. With social-economic development in the developing countries, the trend of etiology and treatment of male urethral stricture changed was speculated. The clinical data of the male patients with urethral stricture from 2000 to 2019 were analyzed. The subjects were divided into Group A (2000-2009) and Group B (2010-2019) according to treatment time. The pooled analysis of the data extracted from pieces of literature was also performed. About 540 patients were included in the present study, including 235 patients in Group A and 305 patients in Group B. In recent 10 years, trauma has still been the main cause of urethral stricture. Iatrogenic injury, especially transurethral operation, increases significantly, while male urethral stricture secondary to radiotherapy and infection decrease. Urethroplasty increases and the reoperation rate decreases in treating simple urethral stricture, and flap urethroplasty also increases in treating complex urethral stricture. The results of a pooled analysis of data from 11 centers in Mainland China are partially consistent with it. Complications, such as urethral fistula, false canal, ejaculation disorder, and penile curvature, decrease significantly. The main causes of urethral stricture in the recent 10 years are still trauma and iatrogenic injuries, and the etiology of urethral stricture is related to socioeconomic development. With the increase of intracavitary minimally invasive treatment and flap urethroplasty, the curative effect is increasing, while iatrogenic urethral stricture cannot be ignored.
男性尿道狭窄是一种发病率较高的疾病。随着发展中国家社会经济的发展，推测男性尿道狭窄的病因和治疗趋势发生了变化。分析了 2000 年至 2019 年男性尿道狭窄患者的临床资料。根据治疗时间将患者分为 A 组（2000-2009 年）和 B 组（2010-2019 年）。还对从文献中提取的数据进行了荟萃分析。本研究共纳入 540 例患者，A 组 235 例，B 组 305 例。近 10 年来，创伤仍是尿道狭窄的主要原因。医源性损伤，特别是经尿道手术明显增加，而放射治疗和感染引起的男性尿道狭窄减少。单纯尿道狭窄的尿道成形术增加，再手术率降低，复杂尿道狭窄的皮瓣尿道成形术也增加。中国内地 11 个中心数据的荟萃分析结果部分与之相符。尿道瘘、假道、射精障碍和阴茎弯曲等并发症明显减少。近 10 年来尿道狭窄的主要原因仍然是创伤和医源性损伤，尿道狭窄的病因与社会经济发展有关。随着腔内微创治疗和皮瓣尿道成形术的增加，疗效增加，而医源性尿道狭窄不容忽视。
