Estado de la urología reconstructiva en Colombia: Tratamiento de la estrechez uretral anterior, una encuesta nacional

The minimally invasive treatment of urethral stricture has higher recurrence and longterm re operation rates. Surveys in other countries have shown that urologists have little experience with open urethroplasty with a preference to the utilization of minimally invasive therapies. We applied a survey to obtain data about practice patterns of the anterior urethral stricture treatment in our country. Methods: A survey was performed with adapted questions to our national context based on several surveys previously conducted in other countries about experience in Reconstructive Urology. This questionnaire included information about age, experience level in general urology, experience in reconstructive urology, scenario of practice, and the preferred techniques handling the pendular and bulbar urethral strictures. All information was collected anonymous and data were analyzed using the statistical software package SPSS, and a frequency distribution analysis was performed. Results: A total of 106 answers from respondent urologists were obtained. For the treatment of pendular urethral strictures the vast majority of respondents prefer the minimally invasive endoscopic treatment, following by graft urethroplasty with percentages of 69.9% and 25.5% respectively. Only 5% prefer to refer their patients for care at a specialized center. Regarding the bulbar urethral the urologists prefers to perform minimally invasive management, followed by urethroplasty and refer to a specialized center in percentages of 44.3%, 41.5% and 14.2% respectively. The younger and more recent urological trained population tends to make more often graft urethroplasty and less endoscopic management, specifically internal urethrotomy. In the intermediate cities there is a predilection for endoscopic treatment especially internal urethrotomy. Conclusions: The minimally invasive treatment approach of urethral stricture is the most frequently chosen despite its poor long-term success rates. It is noteworthy that the new generations of urologists show more interest and mastery of open techniques, which today is the standard treatment with low relapse and long-term re operation rates.