Abstract
Objective
The clinico-pathologic features of urethral stricture in patients with HIV/AIDS are not yet clearly described in the literature. HIV/AIDS has changed the natural course and clinical features of most infectious diseases. We describe some of the features of post-inflammatory strictures associated with HIV Infection and assess the treatment challenges and outcomes of other causes of urethral stricture.
Patients and Methods
Consecutive men with urethral stricture who presented to the University Hospital of Gondar, North-West Ethiopia were enrolled. The HIV status, cause of the stricture, type of treatment and outcome were recorded.
Results
There were 25 post-traumatic and 15 post-gonococcal urethral strictures. All posttraumatic and 5 of the post-gonococcal urethral stricture patients were HIV negative. All 10 HIV positive patients had longer and denser urethral strictures than expected. The time between gonococcal infection and urethral stricture development was 3–5 years in HIV positive patients. The treatment of post-traumatic stricture included progressive perineal anastomotic urethroplasty and a good outcome was seen in more than 95%. However, the surgical treatment of patients with HIV infection was a challenge.
Conclusion
If post-inflammatory urethral stricture occurs in a young man where the time between known gonococcal infection and development of stricture is short (less than 5 years), HIV coinfection is most likely. The stricture in these patients will be longer and denser and not amenable to conventional endoscopic urethrotomy.
Similar content being viewed by others
References
Attwater HL. The history of urethral stricture. Br.J.Urol. 1943;15:39.
Bainbridge DR, Whitaker RH, Shepheard BG. Balanitis xerotica obliterans and urinary obstruction. Br.J.Urol. 1971; Aug;43(4):487–491.
Staff WG. Urethral involvement in balanitis xerotica obliterans. Br.J.Urol. 1970; Apr;42(2):234–239.
Cohen JK, Berg G, Carl GH, Diamond DD. Primary endoscopic realignment following posterior urethral disruption. J.Urol. 1991; Dec;146(6):1548–1550.
Mundy AR. The role of delayed primary repair in the acute management of pelvic fracture injuries of the urethra. Br.J.Urol. 1991; Sep;68(3):273–276.
Lumen N, Hoebeke P, Willemsen P, De Troyer B, Pieters R, Oosterlinck W. Etiology of urethral stricture disease in the 21st century. J.Urol. 2009;182(3):983–987.
Tijani KH, Adesanya AA, Ogo CN. The new pattern of urethral stricture disease in Lagos, Nigeria. Niger. postgrad.med.j. 2009;16(2):162–165.
Blandy J. Two stage scrotal flap urethroplasty. Ann.Urol. (Paris). 1993;27(4):213,8; discussion 219.
Song LJ, Xu YM, Lazzeri M, Barbagli G. Lingual mucosal grafts for anterior urethroplasty: A review. BJU Int. 2009;104(8):1052–1056.
Morey AF, Hernandez J, McAninch JW. Reconstructive surgery for trauma of the lower urinary tract. Urol.Clin. North Am. 1999; Feb;26(1):49,60, viii.
Musau P, Mteta AK. Urethral strictures in a tertiary care hospital in Tanzania. East Afr.Med.J. 2009;86(1):3–6.
Chong YL, Toh KL. Urethroplasty for anterior urethral strictures in a community-based urology practice. Int. Urol.Nephrol. 2007;39(2):505–509.
Author information
Authors and Affiliations
Corresponding author
About this article
Cite this article
Getahun, G.M., Chane, D. Urethral stricture and HIV: Unusual presentations and treatment challenge. Afr J Urol 16, 124–127 (2010). https://doi.org/10.1007/s12301-010-0026-3
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12301-010-0026-3