National Trends in the Management of Urethral Stricture Disease
Niels V. Johnsen, Sarah K. Holt, Jonathan Wingate
Abstract
INTRODUCTION: A growing body of evidence suggests that practice patterns for the management of urethral strictures are changing. We examined national trends in urethral stricture management over time using a national data set. METHODS: Individuals with a new diagnosis of urethral stricture disease between 2008 and 2016 were identified within MarketScan® to determine management strategies. Repeat endoscopic management was defined as 2 or more endoscopic procedures per patient. Recommended care was defined as primary urethroplasty, a single endoscopic procedure or a single endoscopic procedure followed by urethroplasty. Linear regression and multivariate models were fit to determine trends over time. RESULTS: =0.87, p <0.01). On multivariate analysis later year of diagnosis was associated with an increased odds of receiving recommended care while increasing age and increasing comorbidity status were associated with decreased odds. CONCLUSIONS: In a large national sample a significant trend toward decreased use of repeat endoscopic procedures and increased use of urethroplasty for management of urethral stricture disease was noted. These data highlight a drastic change in practice patterns over time, favoring a more definitive evidence-based approach.