MP56-15 AN 18-YEAR ANALYSIS OF STAGED URETHROPLASTY: HOW OFTEN DO PATIENTS SUCCESSFULLY COMPLETE RECONSTRUCTION IN TWO STAGES?

Abstract

You have accessJournal of UrologyTrauma/Reconstruction/Diversion: Urethral Reconstruction (including Stricture, Diverticulum) III (MP56)1 Sep 2021MP56-15 AN 18-YEAR ANALYSIS OF STAGED URETHROPLASTY: HOW OFTEN DO PATIENTS SUCCESSFULLY COMPLETE RECONSTRUCTION IN TWO STAGES? Ziho Lee, Jolie Shen, Aaron Stewart, Desiree Sanchez, Alexander Skokan, and Judith Hagedorn Ziho LeeZiho Lee More articles by this author , Jolie ShenJolie Shen More articles by this author , Aaron StewartAaron Stewart More articles by this author , Desiree SanchezDesiree Sanchez More articles by this author , Alexander SkokanAlexander Skokan More articles by this author , and Judith HagedornJudith Hagedorn More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002086.15AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Although staged urethral reconstruction is ideally performed in two stages, this may not always be possible. We review our 18-year experience with staged oral mucosa graft (OMG) urethroplasty, and assess attrition and complication rates. METHODS: We retrospectively reviewed our urethroplasty database from 04/2001-10/2019 to identify all patients who underwent a first-stage OMG urethroplasty with the intention of completing a multi-stage reconstruction. Surgical success after first stage urethroplasty was assessed between 3-12 months postoperatively and defined as a neo-urethral OMG plate with ≥70% take and amenable to tubularization. Surgical success after second stage urethroplasty was defined as urethral patency (confirmed by evaluation with a 16Fr cystoscope) at time of last follow up. Patients developing urethrocutaneous fistulas and stricture recurrences after second stage urethroplasty were deemed unsuccessful. RESULTS: A total of 160 patients underwent first-stage OMG urethroplasty, and 128 (80.0%) patients were surgically successful. Of 128 patients who successfully underwent first-stage urethroplasty, 104 (81.3%) underwent second-stage urethroplasty and 24 (18.8%) did not undergo second-stage urethroplasty. With regards to patients who underwent successful first-stage urethroplasty but did not undergo second-stage urethroplasty, 13/24 (54.2%) patients were lost to follow up, 8/24 (33.3%) patients elected not to proceed with second-stage urethroplasty, and 3/24 (12.5%) patients had progression of urethral/penile cancer. At a median follow up of 19.5 (IQR 4.0-41.0) months after second-stage urethroplasty, 82/104 (78.9%) patients who underwent second-stage urethroplasty were surgically successful. After second-stage urethroplasty, fistula formation occurred in 12/104 (11.5%) and stricture recurrence occurred in 10/104 (9.6%). Overall, 82/160 (51.3%) patients initially intending to undergo a staged urethroplasty underwent urethral reconstruction in two stages. CONCLUSIONS: Roughly half of patients undergoing staged OMG urethroplasty will undergo successful urethral reconstruction in two stages. Patients considering staged urethroplasty should be counselled on the significant attrition rate, and the possibility of complications such as poor graft take, fistula formation, and stricture recurrence that may necessitate additional surgeries. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e974-e974 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ziho Lee More articles by this author Jolie Shen More articles by this author Aaron Stewart More articles by this author Desiree Sanchez More articles by this author Alexander Skokan More articles by this author Judith Hagedorn More articles by this author Expand All Advertisement Loading ...