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Abstract

An optimal definition for urethroplasty success should include both anatomic and functional outcomes. 1 Erickson B.A. Ghareeb G.M. Definition of successful treatment and optimal follow-up after urethral reconstruction for urethral stricture disease. Urol Clin North Am. 2017; 44: 1-9 Abstract Full Text Full Text PDF PubMed Scopus (33) Google Scholar To objectively assess anatomic success, ideally all patients should undergo cystoscopy at follow up. However, previous data show that about half of the patients will not return for a cystoscopic follow-up at 1 year. 2 Erickson B.A. Elliott S.P. Voelzke B.B. et al. Multi-institutional 1-year bulbar urethroplasty outcomes using a standardized prospective cystoscopic follow-up protocol. Urology. 2014; 84: 213-216 Abstract Full Text Full Text PDF PubMed Scopus (60) Google Scholar Factors such as lack of symptoms, being remote from the clinic, lack of time, and unwillingness to undergo another cystoscopy are among the reasons for low follow-up rates. 1 Erickson B.A. Ghareeb G.M. Definition of successful treatment and optimal follow-up after urethral reconstruction for urethral stricture disease. Urol Clin North Am. 2017; 44: 1-9 Abstract Full Text Full Text PDF PubMed Scopus (33) Google Scholar Lack of cystoscopic follow-up in 12 of 35 (34%) patients in our study is in line with this. However, all these patients were interviewed and met the criteria for clinical and functional success as previously described. 2 Erickson B.A. Elliott S.P. Voelzke B.B. et al. Multi-institutional 1-year bulbar urethroplasty outcomes using a standardized prospective cystoscopic follow-up protocol. Urology. 2014; 84: 213-216 Abstract Full Text Full Text PDF PubMed Scopus (60) Google Scholar Although it is known that up to 35% of asymptomatic patients may have strictures at cystoscopy (anatomic failure), the significance of anatomic failure in an asymptomatic and satisfied patient is unknown. This also raises the question if becoming aware of an asymptomatic cystoscopic stricture would negatively affect a patients' conception about success and his satisfaction with the surgery, thereby affecting his quality of life.