839 URETHROPLASTY USING BUCCAL MUCOSA IS A HIGHLY EFFECTIVE TREATMENT OF URETHRAL STRICTURES IN THE ELDERLY

Abstract

You have accessJournal of UrologyPenis/Testis/Urethra: Benign & Malignant Disease1 Apr 2011839 URETHROPLASTY USING BUCCAL MUCOSA IS A HIGHLY EFFECTIVE TREATMENT OF URETHRAL STRICTURES IN THE ELDERLY Hendrik Isbarn, Luis Kluth, Oliver Balzer, Oliver Engel, Lars Budäus, Daniel Pfalzgraf, Philipp Reiss, Felix Chun, Christian Eichelberg, Eike Eichelberg, Silke Riechardt, Andreas Becker, Sascha Ahyai, Roland Dahlem, and Margit Fisch Hendrik IsbarnHendrik Isbarn Hamburg, Germany More articles by this author , Luis KluthLuis Kluth Hamburg, Germany More articles by this author , Oliver BalzerOliver Balzer Hamburg, Germany More articles by this author , Oliver EngelOliver Engel Hamburg, Germany More articles by this author , Lars BudäusLars Budäus Hamburg, Germany More articles by this author , Daniel PfalzgrafDaniel Pfalzgraf Hamburg, Germany More articles by this author , Philipp ReissPhilipp Reiss Hamburg, Germany More articles by this author , Felix ChunFelix Chun Hamburg, Germany More articles by this author , Christian EichelbergChristian Eichelberg Hamburg, Germany More articles by this author , Eike EichelbergEike Eichelberg Hamburg, Germany More articles by this author , Silke RiechardtSilke Riechardt Hamburg, Germany More articles by this author , Andreas BeckerAndreas Becker Hamburg, Germany More articles by this author , Sascha AhyaiSascha Ahyai Hamburg, Germany More articles by this author , Roland DahlemRoland Dahlem Hamburg, Germany More articles by this author , and Margit FischMargit Fisch Hamburg, Germany More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.659AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES It is widely accepted that urethroplasty using buccal mucosa is an effective and save surgical approach for the treatment of urethral strictures. However, little is known about its efficacy in elderly patients. The objective of this study was to evaluated the stricture-recurrence free survival rates in patients ≥65 years, treated with skin graft urethroplasty at our institution. METHODS We identified 48 consecutive patients ≥65 years, who were treated with open urethroplasty using buccal mucosa at our institution by high volume surgeons between 12/2008 to 06/2010. In 37 cases (77.1%), a dorsal onlay technique was used, 7 patients (14.6%) were treated with a modified Barbagli technique, as previously described, and for the remaining 4 patients (8.3%), an inlay was used. Stricture recurrence was defined as any further surgical intervention after urethroplasty. The stricture recurrence free survival was assessed using the Kaplan Meier method and life tables. Postoperative Quality of life (QoL) assessment was performed by means of standardized, non-validated questionnaire. RESULTS The median patient age at surgery was 71 years. Stricture locations were bulbar, penile, bulbopenile, and meatal in respectively 67, 21, 10, and 2% of cases. Graft lengths were ≥2cm in 4 patients (8%), 3–5cm in 32 patients (67%), and ≥6cm in 12 patients (25%), respectively. The vast majority of patients (85%) had had previous urethral surgery, such as urethrotomia interna and/or open urethral reconstruction. No severe perioperative complications were observed. The mean follow-up of censored patients was 10 months. After surgical intervention at our institution, the one-year stricture recurrence free survival rate was 81 %. Eighty percent of patients stated that their postoperative QoL either slightly or very much improved. Moreover, 82% were satisfied or very much satisfied with the surgical outcome. CONCLUSIONS Our results indicate that even in the elderly, urethroplasty using buccal mucosa for the treatment of urethral strictures is a highly successful surgical approach. However, longer follow-up is required to guarantee its enduring efficacy in such individuals. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e337 Peer Review Report Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Hendrik Isbarn Hamburg, Germany More articles by this author Luis Kluth Hamburg, Germany More articles by this author Oliver Balzer Hamburg, Germany More articles by this author Oliver Engel Hamburg, Germany More articles by this author Lars Budäus Hamburg, Germany More articles by this author Daniel Pfalzgraf Hamburg, Germany More articles by this author Philipp Reiss Hamburg, Germany More articles by this author Felix Chun Hamburg, Germany More articles by this author Christian Eichelberg Hamburg, Germany More articles by this author Eike Eichelberg Hamburg, Germany More articles by this author Silke Riechardt Hamburg, Germany More articles by this author Andreas Becker Hamburg, Germany More articles by this author Sascha Ahyai Hamburg, Germany More articles by this author Roland Dahlem Hamburg, Germany More articles by this author Margit Fisch Hamburg, Germany More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...