Male Urethral Stricture Disease

Abstract

Purpose: The incidence of urethral stricture disease in the United States is unknown. We estimated the impact of urethral stricture disease by determining its prevalence, costs and other measures of burden, including side effects and the need for surgical intervention. Materials and Methods: Analyses of services for urethral stricture disease were performed in 10 public and private data sets by epidemiological, biostatistical and clinical experts. Results: Male urethral stricture disease occurred at a rate as high as 0.6% in some susceptible populations and resulted in more than 5,000 inpatient visits yearly. Yearly office visits for urethral stricture numbered almost 1.5 million between 1992 and 2000. The total cost of urethral stricture diseases in 2000 was almost $200 million, not including medication costs. A diagnosis of urethral stricture increased health care expenditures by more than $6,000 per individual yearly in insured populations after controlling for comorbidities. Urethral stricture disease appeared to be more common in the elderly population and in black patients, as measured by health care use. In most data sets services provided for urethral stricture disease decreased with time. Patients with urethral stricture disease appeared to have a high rate of urinary tract infection (41%) and incontinence (11%). Conclusions: Despite decreasing rates of urethral strictures with time the burden of urethral stricture disease is still significant, resulting in hundreds of millions of dollars spent and hundreds of thousands of caregiver visits yearly.