5 OUTCOME OF DORSAL BUCCAL GRAFT AUGMENTED ANASTOMOSIS FOR URETHRAL STRICTURES AFTER A FAILED RECONSTRUCTION

Abstract

You have accessJournal of UrologyTrauma/Reconstruction: Trauma & Reconstructive Surgery1 Apr 20115 OUTCOME OF DORSAL BUCCAL GRAFT AUGMENTED ANASTOMOSIS FOR URETHRAL STRICTURES AFTER A FAILED RECONSTRUCTION Erik Grossgold, Britton Tisdale, Christopher Bayne, Lisa Parrillo, Jeremy Tonkin, Kurt McCammon, and Gerald Jordan Erik GrossgoldErik Grossgold Norfolk, VA More articles by this author , Britton TisdaleBritton Tisdale Norfolk, VA More articles by this author , Christopher BayneChristopher Bayne Norfolk, VA More articles by this author , Lisa ParrilloLisa Parrillo Norfolk, VA More articles by this author , Jeremy TonkinJeremy Tonkin Norfolk, VA More articles by this author , Kurt McCammonKurt McCammon Norfolk, VA More articles by this author , and Gerald JordanGerald Jordan Norfolk, VA More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.066AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Buccal graft augmented anastomosis (BGAA) can be an excellent option for bulbar urethral strictures that are not amenable to primary anastomotic techniques. This can be even more challenging when dealing with a previously reconstructed urethra. We performed this study to examine the outcomes and complications of BGAA for recurrent urethral strictures after a failed reconstruction. METHODS 76 patients underwent BGAA between 2000–2009. Of these, 28 (37%) had prior open urethral reconstruction. Their charts were retrospectively reviewed, and the patients were contacted by phone and asked about ongoing symptoms. Failure was defined as recurrent stricture requiring intervention. Patients underwent voiding urethrography at 3 weeks post-surgery, and cystourethroscopy at 6 months post-surgery. Patients were followed annually thereafter with subsequent endoscopic/radiographic studies performed in symptomatic patients. RESULTS Mean age was 46 years. Follow-up averaged 862 days (25 to 3424). Stricture etiology was idiopathic in 13 (46%), instrumentation in 5 (18%), perineal trauma in 4 (14%), post-hypospadias repair in 4 (14%), and post-infectious in 2 (7%). Mean stricture length was 6.4 cm (2 to 15). One graft was used in 16 patients (57%), and two were used in 12 (43%). All patients had at least one prior open reconstruction. 20 patients were available by phone, 4 had moved and/or changed their numbers, 3 did not return the call, and 1 patient was deceased. Of those contacted, 15 report no significant problems, 1 has improved force of stream on tamsulosin, 1 reports occasional post-void dribbling, 1 requires clean intermittent catheterization for neurogenic bladder secondary to multiple sclerosis, and 2 patients (10%) recurred. Both patients who recurred reported symptomatic improvement after subsequent urethrotomies. Post-operative complications include a pulmonary embolus in a patient found to have a coagulopathy. Occasional UTI was found in 7 patients (25%). New onset erectile dysfunction or subjective worsening of existing erectile dysfunction was reported in 4 patients (14%). 2 patients had post-operative scrotal paresthesias. 1 patient developed a viral gastroenteritis in the immediate post-operative period. CONCLUSIONS BGAA for recurrent urethral stricture disease after a failed reconstruction can be safe and effective with a success rate of 90%. Continued surveillance of these patients with longer follow-up is required to confirm these findings. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited bySiegel J, Panda A, Tausch T, Meissner M, Klein A and Morey A (2018) Repeat Excision and Primary Anastomotic Urethroplasty for Salvage of Recurrent Bulbar Urethral StrictureJournal of Urology, VOL. 194, NO. 5, (1316-1322), Online publication date: 1-Nov-2015.Blaschko S, McAninch J, Myers J, Schlomer B and Breyer B (2018) Repeat Urethroplasty After Failed Urethral Reconstruction: Outcome Analysis of 130 PatientsJournal of Urology, VOL. 188, NO. 6, (2260-2264), Online publication date: 1-Dec-2012. Volume 185Issue 4SApril 2011Page: e2 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Erik Grossgold Norfolk, VA More articles by this author Britton Tisdale Norfolk, VA More articles by this author Christopher Bayne Norfolk, VA More articles by this author Lisa Parrillo Norfolk, VA More articles by this author Jeremy Tonkin Norfolk, VA More articles by this author Kurt McCammon Norfolk, VA More articles by this author Gerald Jordan Norfolk, VA More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...