MP35-19 DECREASED SUCCESS OF GERIATRIC BULBAR URETHROPLASTY

Abstract

You have accessJournal of UrologyTrauma/Reconstruction/Diversion: Urethral Reconstruction (including Stricture, Diverticulum) I (MP35)1 Apr 2020MP35-19 DECREASED SUCCESS OF GERIATRIC BULBAR URETHROPLASTY Jeffrey Wooliscroft*, Nicolas Ortiz, Adam Baumgarten, Ellen Ward, Steven Hudak, and Allen Morey Jeffrey Wooliscroft*Jeffrey Wooliscroft* More articles by this author , Nicolas OrtizNicolas Ortiz More articles by this author , Adam BaumgartenAdam Baumgarten More articles by this author , Ellen WardEllen Ward More articles by this author , Steven HudakSteven Hudak More articles by this author , and Allen MoreyAllen Morey More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000879.019AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Recent studies suggest that older men may have decreased success rates after urethroplasty. We hypothesize that older men have lower success rates after bulbar stricture repair. We aimed to compare stricture characteristics, method of repair, and outcome in patients undergoing bulbar urethroplasty in young, middle, and older aged patient groups. METHODS: We retrospectively reviewed our single–surgeon urethral stricture database between 2007 and 2019. Men were age-stratified into cohorts based on age at the time of surgery. These criteria were chosen to represent the wide range at which bulbar stricture patients present including young (≤30), middle (31-60), and older age (>60) patient cohorts. Surgical success rate, mean stricture length, and stricture method of repair were analyzed. We included only selected patients with isolated bulbar urethral strictures; for this reason, individuals with history of hypospadias, penile strictures, posterior urethral strictures, perineal urethrostomy, and pelvic radiotherapy were excluded as they represent pathologic processes outside the focus of this study. RESULTS: We identified 654 patients with isolated bulbar urethral strictures. Of these, 130 (19.87%) were younger than 30 years old, 340 (51.99%) were 31-60, and 184 (28.13%) were older than 60. Over a median follow-up of 35.2 months, overall success rates decreased as patients advanced in age between cohorts (97.7% vs. 91.4% vs. 88.8%, p=0.01). Mean stricture length was significantly longer in patients aged 31-60 and over 60 compared to patients under 30 (2.81 cm and 2.80 cm vs. 2.26 cm respectively, p=0.005). Urethroplasty with buccal mucosal graft (BMG) had decreased success rates among men greater than 60 (90.9% vs. 90.9% vs. 70%, p=0.01) while the success rate of excision and primary anastomosis (EPA) remained constant in all age cohorts (98.7% vs. 93.5% vs. 95%, p>0.05). Both older patient cohorts were less frequently managed with excision and primary anastomosis than younger men (71.2% and 60.8% vs. 82.3% respectively, p=0.0002). CONCLUSIONS: Among patients who underwent bulbar urethroplasty, older men had the lowest overall success rate. Patients treated with EPA urethroplasty appeared to have better success than those treated with BMG urethroplasty. Regardless of technique, urethral reconstruction remains a safe and effective treatment for aging males with bulbar urethral strictures. Source of Funding: None © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e520-e520 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Jeffrey Wooliscroft* More articles by this author Nicolas Ortiz More articles by this author Adam Baumgarten More articles by this author Ellen Ward More articles by this author Steven Hudak More articles by this author Allen Morey More articles by this author Expand All Advertisement PDF downloadLoading ...