Urethral stricture disease (USD) is a complex urological condition that affects quality of life and increases healthcare costs. Most cases are acquired, with 45% due to medical procedures, 30% from minor trauma, and 20% linked to untreated infections. Recent studies suggest low testosterone may contribute to fibrosis in USD, as androgens appear to help reduce inflammatory processes and fibrosis formation. We propose a prospective case-control study to explore the relationship of serum testosterone in USD patients at our center.

Type of study : Prospective case control Sample size : 60 patients Place of study : AIIMS Jodhpur , India ( Tertiary health care center ) Inclusion criteria: Patients will be divided into two groups Group A: Patients coming to our Urology clinic and diagnosed with urethral stricture disease Group B: Patients coming to urology OPD and diagnosed with urological diseases other than urethral stricture disease Exclusion criteria Age less than 18 years old . Patients who did not provide consent. Age <16 years

In patients with urethral stricture, the mean age was 46.1 years, compared to 44.8 years in the placebo group. Stricture length was greater than 2 cm in 20% of cases, between 1–2 cm in 22%, and less than 1 cm in 8%. Strictures were located in the pan-anterior region in 25% of cases, bulbo-membranous in 3%, bulbar in 17%, and penile in 5%. The mean testosterone level in urethral stricture patients was 344.7 ± 122.6 ng/dL, significantly lower than the placebo group’s mean of 498.96 ± 112.3 ng/dL. Free testosterone was also lower in stricture patients, averaging 9.2 ± 3.1 ng/dL, while the placebo group averaged 12.51 ± 2.81 ng/dL. Testosterone deficiency was observed in 15% (n=9) of stricture patients, whereas only 3% of the placebo group exhibited deficiency.

This study underscores a notable correlation between reduced testosterone levels and urethral stricture disease. Patients with USD exhibited significantly lower mean testosterone and free testosterone levels than the placebo group, suggesting a potential link between testosterone deficiency and stricture formation. These findings warrant further investigation into the role of androgen supplementation or testosterone regulation as a potential avenue for managing USD. Additionally, given the diversity in stricture location and length, future studies should explore how testosterone deficiency may influence these factors.