To identify trends in the management and prevalence of urethral stricture disease in Australia over a period of two decades.

Databases related to urethral procedures between financial year (FY) 2000/01 to 2022/23 were sourced from Australian Institute of Health & Welfare and Medicare Benefits Scheme (MBS). The data includes information on length of stay and procedure counts based on age, gender, and procedure type. Nationwide and state financial burden was estimated from MBS benefit/services.

Between FY2000/01-2022/23, there is a decreasing trend in urethral procedures performed. We observed a 9% increase in urethroplasty and 9% decrease in urethral dilatation, while urethral incision is the most commonly performed procedure. Number of urethral procedures performed increases with age and commonly performed in 70-79 years old. There is a rise in urethroplasty performed in younger patients. The ratio of urethroplasty to endoscopic procedures has shifted from 1:13.1 to 1:4.7 in the last two decades. The estimated length of stay related to urethral procedures has reduced from 2.07 to 1.37 days. MBS data demonstrated an estimated increase in nationwide cost of urethral procedures from $624,012 (FY2002/03) to $877,915 (FY2022/23).

Within the last two decades, there is a reduction in urethral procedures performed nationwide, though there is a rise in urethroplasty and reduction in dilatation procedures. Despite fewer procedures performed, the estimated financial burden has increased nationwide and notably in urethroplasty. We observed more urethral procedures performed in older males, with a notable increased uptake in urethroplasty in younger patients.