The relationship of heart failure, chronic obstructive lung disease, and cigarette use with the development of urethral stricture

Objective: In this study; Transurethral Resection of the Prostate performed, who were developed urethral stricture or not during their follow-up were evaluated. Our aim was to evaluate the relationship between Heart Failure, Chronic Obstructive Pulmonary Disease and smoking with the development of urethral stricture. Materials and Methods: Patients aged between 50 and 80 years who underwent Transurethral Prostate Resection in our clinic were included in the study on a voluntary basis. Among these patients, 50 patients who developed urethral stricture during their follow-up were included into group 1, and 50 patients who did not develop urethral stricture were included into group 2 randomly. Age, height, weight, amount of cigarettes consumed, prostate volume, maximum urine flow rate, postvoid residual urine volume, IPSS score, operation time and catheter removal times were examined. cardiology and chest diseases consultation reports and pulmonary function test results performed routinely in patients were reviewed. In addition, the conditions of heart failure and chronic obstructive pulmonary disease information were informed, taking into account the forms those were filled form the verbal information obtained from the patients, and the results of the consultation. During the follow-up of the patients, the development time of urethral stricture and the information about the internal urethrotomy procedure were evaluated. All patients were followed for at least 6 months. Results: There was no statistically significant difference in the data of the patients such as age, prostate volume, maximum urine flow rate, IPSS score, operation time and catheter removal time. Body mass index and postvoid residual urine volume of patients in group 1 were found to be statistically significantly higher than group 2 (respectively; p=0.015, p=0.007).While the mean±SD value of the amount of cigarettes consumed by the patients in group 1 was 23.78±18.2 pack/year and it was found as 13.94±19.94 pack/year in group 2. The mean amount of cigarettes consumed was statistically significant in the stricture group (p=0.007).While the rate of symptomatic hearth failure was 56% in group 1, this rate was 26% in group 2. When the patients with and without symptomatic heart failure were analyzed in the cross table with group 1 and group 2, the chi-square test was found to be statistically significant (p=0.002). Similarly; while the rate of chronic obstructive pulmonary disease was 48% in group 1, this rate was 22% in group 2. When examined in the cross table, the chi-square test was found to be statistically significant (p=0.006). Examined mMRC scales and CAT scores were statistically significantly higher in group 1 (respectively; p=0.003, p=0.002). Moreover; pulmonary function test parameters of patients such as FEV1, FVC and FEV1/FVC were found to be statistically significantly higher in group 2 (respectively; p<0.001, p<0.001, p=0.008). Conclusion: Iatrogenic causes are most commonly encountered in the etiology of urethral stricture. Therefore, it is important to investigate the factors that predispose urethral stricture development. In our study, we concluded that smoking, heart failure and chronic obstructive pulmonary disease significantly increase the risk of stricture development after transurethral resection of the prostate. Keywords: Urethral stricture, Transurethral resection of the prostate, Smoking, Chronic obstructive pulmonary disease, Heart failure.