A retrospective analysis of delayed complications of urethroplasty at a tertiary care centre

Abstract

Urethroplasty is commonly performed worldwide by reconstructive urologists and such a large scale practice is often faced with numerous complications, yet "complication based analysis" still persists as a gray area. Our study aims to provide an evaluation of long-term post-urethroplasty complications, after the five commonly practiced procedures, at our centre. 302 male patients with urethral strictures due to various etiologies were assessed preoperatively via retrograde urethrogram, urethrosonogram, and uroflowmetry. They were then subjected to different urethroplasty techniques viz. tunica albuginea urethroplasty (TAU), U-shaped prostato-bulbar anastomosis (USPBA), dorsal buccal mucosa graft urethroplasty, skin substitution urethroplasty and Dartos flap urethroplasty. Postoperatively, patients were assessed at regular intervals, regarding the occurrence of complications. The overall complication rate was 21% at 5years follow-up, with the majority during the initial 2years. Infection and restenosis were the major long-term complications (12%). Maximum complications were seen in patients, who underwent TAU and USPBA simultaneously followed by Dartos flap urethroplasty and minimum were seen with TAU. In conclusion, a meticulous post-urethroplasty follow-up reveals a wide range of long-term complications. The complication rate differs in accordance with the etiology, site and length of stricture as well as the reconstructive technique.