[Complications of the lower urinary tract secondary to urethral stenosis]

Among the complications from urethral stenosis those derived from obstructive uropathy of the lower urinary tract and genitalia should be pointed out for their high frequency, the low attention they are given and their potential seriousness. Such complications are related to urinary infection and favoured by the anatomical and functional changes stenosis causes on urinary and genital organs. This paper analyzes the complications in the lower urinary tract in a group of 175 male patients with urethral stenosis, diagnosed at the General Teaching Hospital in Alicante between January 1977 and January 1990. 154 complications of the lower urinary tract (LUT) were reported in 124 patients (71%) out of the initial 175. In 86 patients (49%) these complications were isolated, whereas in 38 patients (22%) they coexisted with other in the genitalia. Frequency ranking of LUT complications was: fight bladder (68% patients), vesical diverticulosis (19%), chronic prostatitis (13%), megabladder (10%), vesical lithiasis (6%), urethral lithiasis (4%), urethral diverticulum (4%) and chronic periurethritis (2%). Renal failure developed in 25 patients (20%), and progressed to CRI in 3 (2%). Urinary infection occurred in 59 (48%) patients, primarily by urolithic germs (24%). Management of the 124 urethral stenosis required a total of 159 procedures, but only 20 (13%) of the 154 complications required surgery. We conclude that patients with urethral stenosis have frequent LUT complications, and that long-term male stenosis associated to urinary infection is a risk factor. Surgery tends to be the preferred treatment option for both stenosis and some of the complications.