Abstract
Objective: This study evaluated the outcomes of urethroplasty performed in male
patients by a single surgeon.
Methods: A retrospective review of male patients who underwent substitution
urethroplasty by a single surgeon was performed. Baseline and perioperative parameters
were recorded. Follow-up involved a pericatheter urethrogram at 3 weeks, a
flow study at 8 weeks, and cystoscopic calibration within 6 to 12 months. Patient
satisfaction was assessed using the Patient Global Impression of Improvement questionnaire.
Primary outcome was functional success, as defined by no need for further
intervention. Secondary outcomes were complications, patient satisfaction, and factors
associated with stricture recurrence.
Results: Sixty male patients were included; two were lost to follow-up. Median
patient age was 47 years (range 17–83 years). Mean stricture length was 5 cm (range
1.5–18 cm). Urethroplasty was performed using buccal mucosa graft repair in
53 patients (92%), flap repair in three patients (5%), and a combination of both techniques
in two patients (3%). All complications were Clavien–Dindo Grade I to III,
recorded in 20 patients (34%). At a mean follow-up of 50 months (range
12–124 months), functional success was evident in 90% of patients. Cystoscopic calibration
at 6 to 18 months was performed in 28 patients (49%). Most patients (93%)
reported a better quality of life after the procedure. Oral complications were low
grade and uncommon (6%). Stricture recurrence was not related to age, stricture
length, or etiology (all P > 0.05).
Conclusions: Substitution urethroplasty has a high success rate, durable response,
and high patient satisfaction. Standardization of surveillance protocol after
urethroplasty is recommended.
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2019
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