756 URETHROPLASTY AFTER RADIOTHERAPY A SINGLE-INSTITUTIONAL EXPERIENCE

Abstract

You have accessJournal of UrologyPenis/Testis/Urethra: Benign & Malignant Disease II1 Apr 2012756 URETHROPLASTY AFTER RADIOTHERAPY A SINGLE-INSTITUTIONAL EXPERIENCE Khalid Sayedahmed, Björn Theodor Kaftan, Thomas Jachertz, and Roberto Olianas Khalid SayedahmedKhalid Sayedahmed Lüneburg, Germany More articles by this author , Björn Theodor KaftanBjörn Theodor Kaftan Lüneburg, Germany More articles by this author , Thomas JachertzThomas Jachertz Lüneburg, Germany More articles by this author , and Roberto OlianasRoberto Olianas Lüneburg, Germany More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.842AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES External-beam radiation and radioactive iodine-125 or palladium seeds are becoming more widespread in the treatment of localized prostate cancer. Late complications of radiation therapy may occur months or years following the completion of treatment. Reconstructive surgery after exposure to radiotherapy is known to be a challenge due to impaired blood supply and wound healing. We present our results of urethroplasty in patients with previous history of radiation therapy. METHODS Retrospective analysis of the outcome of 25 previously irradiated patients, who underwent urethroplasty. N=17 and n=8 patients underwent end-to-end and buccal mucosal graft urethroplasty, respectively. All cases were operated in the same institute by the same surgeon. Recurrence was defined as cystoscopic finding of stricture less than 17 Fr in diameter. Complication rate was the end point of this study. RESULTS Mean age of all patients was 66 years (range 54-82 years). Mean dose of radiotherapy was 84.2 Grey. Mean length of stricture was 3.5 cm (Range 1-7.5 cm). Stricture was located in bulbo-membranous urethra in 19 (76%), bulbar urethra in 4 (16 %) and in penile urethra 2 (8%) of patients. The mean follow-up of the patients was 24.2 months (range 7 - 56 months). The urethroplasty was successful without recurrence during the follow-up in 72% of cases. Recurrent stricture was managed with visual internal urethrotomy in 2 (8%) and with buccal mucosal graft in 3 (12%) of patients. Urinary diversion was required in 2 (8%) of patients. However 10 (40%) of patients developed postoperative urinary incontinence, artificial urethral sphincter was successfully implanted in 60% of them. There were no cases of new onset of erectile dysfunction after urethroplasty. 88% of patients were satisfied and reported significant improvement of quality of life. CONCLUSIONS The results of urethroplasty in patients with previous history of exposure to radiotherapy, in experienced hands, are better than expected. The high incidence of postoperative urinary incontinence has to be considered. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e309 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Khalid Sayedahmed Lüneburg, Germany More articles by this author Björn Theodor Kaftan Lüneburg, Germany More articles by this author Thomas Jachertz Lüneburg, Germany More articles by this author Roberto Olianas Lüneburg, Germany More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...