UP-111 The burden of urethral stricture disease in the province of Ontario
Thursday June 27, 2019 from

R. Christopher Doiron, Canada

Assistant Professor

Department of Urology

Queen's University


The burden of urethral stricture disease in the province of Ontario

R. Christopher Doiron1, Marlo Whitehead2, Christopher M. Booth2,3,4, D. Robert Siemens1,3,4.

1Urology, Queen's University, Kingston, ON, Canada; 2ICES Queen's, Health Services and Policy Research Institute , Queen's University , Kingston, ON, Canada; 3Oncology , Queen's University, Kingston, ON, Canada; 4Division of Cancer Care and Epidemiology, Queen's University, Kingston, ON, Canada

Introduction: Urethral stricture disease (USD) is a rare, but frequently morbid condition while access to Canadian surgeons with expertise in urethroplasty is lacking. We describe the burden of USD in the province of Ontario and explore management patterns.

Methods: All male patients with USD in the province of Ontario who received care related to their diagnosis between Apr 2002 – Mar 2020 were identified using data from the Institute for Clinical Evaluative Sciences. Analysis of health care utilization included outpatient, inpatient and emergency department visits for care related to their stricture diagnosis.

Results: A total of 118,721 men were identified with a urethral stricture diagnosis during the study period – 66,868 incident cases and 51,853 prevalent cases. Overall median (IQR) age at time of diagnosis was 61 (44-72). Over the study period, 2.1% (n=2,448) of patients visited emergency departments (ED) ≥1 due to USD, while 27.3% (n=32,390) had ≥1 ED visit for diagnoses other than USD, determined to be a complication secondary to USD. A total of 12.2% (n=14,464) of patients required ≥1 urologic USD–associated intervention in the ED, while 1.7% (n=2,102) required ≥3. Over half (52.2%; n=61,982) of patients were seen in outpatient consultation directly related to USD and 68% (n=80,773) were seen for a non-USD diagnosis determined to be a complication secondary to USD. Patients underwent a mean (SD) of 7.6 (±23.5) diagnostic procedures and 1.4 (±5.4) endoscopic interventions as treatment of their USD during the study period. A total of 1,386 patients (1.2%) underwent a single open reconstruction for treatment of their urethral stricture, while n=253 (0.2%) had ≥2 open procedures during the study period.

Conclusions: USD is not rare, carries a significant burden on the health care system in Ontario with few receiving definitive treatment with urethroplasty.

Lectures by R. Christopher Doiron

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