Abstract
PURPOSE: There is a wide range of surgical treatments for urethral strictures. There is no information on the extent to which these procedures have been used over the past few years. METHODS: We analyzed data from Diagnosis Related Groups (DRG) billing data from DESTATIS. Linear regression models were utilized for the analysis of trends over time. RESULTS: A significant decrease of male urethral stricture cases during the study period was observed. Cases decreased from 48,020 cases in 2006 to 33,062 cases in 2023, i.e. -31%. This decline was mainly driven by the decrease in cases in the younger age group (≤ 79 years), whereas a significant increase was noted in octogenarians (+ 24%). A total of 834,476 procedures for urethral stricture disease were analyzed. In accordance with total case numbers, inpatient surgical interventions for urethral stricture disease decreased by 39% during the study period. Internal urethrotomy significantly decreased by 50% (from 41,443 in 2006 to 20,777 in 2023; p < 0.001). Likewise, urethral dilatations significantly decreased by 17% (from 14,134 in 2006 to 11,674 in 2023; p = 0.002). On the contrary, urethroplasties significantly increased by 156% (from 873 in 2006 to 2,239 in 2023; p < 0.001). CONCLUSION: We present contemporary data on urethral stricture disease management in Germany. Case numbers of internal urethrotomies and urethral dilatations are declining while urethroplasty is increasingly utilized as a definitive treatment for urethral stricture disease. This may reflect an optimized treatment of urethral strictures with more urethroplasties and thus fewer relapses to be treated.