5 REDO URETHROPLASTY AFTER FAILURE OF END-TO-END ANASTOMOTIC BULBAR URETHROPLASTY

Abstract

You have accessJournal of UrologyTrauma/Reconstruction: Trauma & Reconstructive Surgery I1 Apr 20125 REDO URETHROPLASTY AFTER FAILURE OF END-TO-END ANASTOMOTIC BULBAR URETHROPLASTY Andre Cavalcanti and Mauricio Rubinstein Andre CavalcantiAndre Cavalcanti Rio de Janeiro, Brazil More articles by this author and Mauricio RubinsteinMauricio Rubinstein Rio de Janeiro, Brazil More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.047AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES End-to-end anastomotic urethroplasty (EEA) for bulbar urethral stricture is associated with excellent long-term success rate: superior to 90% in the majority series. The management of the failures after this type of surgery is an uncommon subject on the literature . The aim of this study is to describe our experience with the surgical management of failures after EEA for bulbar urethral strictures. METHODS The charts of 33 patients submitted to a redo urethroplasty after failure of EEA for bulbar strictures were analysed. All surgeries were performed by the same surgeon between january 2006 and march 2011. The mean follow-up was 30.8 months (range from 6 to 63 months). The mean age was 45.9 years (range from 21 to 83 years). Successful urethral reconstruction was defined as normal voiding (max. flow rate > 15 ml/s) without the need for any postoperative procedure. All patients with max. flow rate < 15 ml/s were submitted to a urethrogram or cystoscopy to evaluate the urethral caliber. The stricture length range from 1 cm to 4 cm (mean of 2,8 cm). RESULTS 29 (87.9%) patients were treated with a single stage procedure and 4 (12.1%) with a staged procedure with buccal mucosa graft (BMG). In 6 (18.2%) patients a new EEA was performed and 23 (69,7%) were treated with a single staged substitution urethroplasty witha a BMG in diferent techniques: ventral onlay (4), dorsal onlay (9), dorsal augmented urethroplasty (7) and double graft (3). The success rate was 81,8% (27 pts) , with 6 failures. Permanent erectile dysfunction were observed in 5 patients (15.2%) and ejaculatory symptoms in 7 patients (21.2%). CONCLUSIONS Good success rate can be expected after a redo urethroplasty on bulbar urethra. The use of a diversity of techniques is necessary to find the best procedure for each patient, regarding the stricture characteristics: lenght, position and spongiosum quality. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e2 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Andre Cavalcanti Rio de Janeiro, Brazil More articles by this author Mauricio Rubinstein Rio de Janeiro, Brazil More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...