Introduction:
Urethroplasty was has been a challenge In Gambia.
Substitution urethroplasties have been unavailable due to multiple factors .
Substitution urethroplasty was commenced regularly only in 2018 by a single surgeon.
We present the patient demography, surgical technique and outcomes of 51 patients .
These patients either have  anastomotic urethroplasty or substitution urethroplasties.
Period of  review was September 2018 to September 2022 (1-3yrs followup).


To outline demographic distributions of urethral stricture

Establish etiological causes of urethral strictures

Outline urological procedures  done in management of urethral stricture

Establish surgical outcome of urethroplasty

Method
Study place:  Sharab Medical center (Sharab Hospital Ltd)
Study Population: Urethroplasty patient ( September 2018 to September 2022)
Type of study: Retrospective study 
Interview using standardize questionnaire on LUTS or development of new symptoms
Interview  via phone call or direct interview using questionnaire

The results were discussed under the following :

Age distributions
Position of stricture
Mechanisms/ causes of urethral stricture
Length of stricture
Usage of Suprapubic catheter
Duration of symptoms
outcome of surgery



    Outcome	                       Number
Symptom (LUTS) free	          45  ( 88 %)
LUTS	                                   2
Anastomotic Leak	           1
Dead	                                   2
No Follow up	                           1
Total	                                   51

Age group	      number
<30	                          5
30-39	                 12
40-49	                  11
50-59	                  11
60-69	                   3
70+                        	   4
Total	                   46

Position of stricture	        Number
Proximal Bulbar	                   15
Midbulbar	                          12
Distal bulbar	                         10
Proximal penile	                  10
Midpenile	                            2
Pan urethral	                            2
Total	                                   51

Mechanism/ Cause of Stricture	      Number     (%)
 Pelvic injury	                                                    6
Catherisation	                                            8
Urethritis	                                                    5
BXO	                                                             1
Unknown	                                                    26
TOtal	                                                            46 (100%)


  Lenght of stricture	    Number
  Less than 1.5cm	            9
   1.5 - 3cm	                           14
   more than 3cm	                     28


   Intervention	                        Number/frequency
Previous intervention                          18
No previous Intervention	                 33
Total	                                                  51


     Surgical procedure	                                      Number (%)
   Anastomotic	                                                    18
   BUMG Urethroplasty	                                              26
   1st and 2nd stage 	                                                7
    Total   	                                                                51

Urethral stricture disease is prevalent in The Gambia

Most (82%) of the strictures are more than 1.5cm long

Most (57%) of the causes of urethral strictures was unknown

Trauma (Pelvic injury and catherisation) contributed to 30% of causes
Sharab Hospital Ltd (The Gambia) has registered a very good ( 88% ) outcome on urethroplasty within the study period

Urethral stricture is a common and complex urological condition

Treatment is challenging but outcome are good with an experience hand 

Urethritis is still an important cause of uthral stricture

Trauma and iatrogenic now very common in developing countries

Simple procedures like urethral catherisation is now a very common cause of urethral stricture