PD22-02 TRANSECTED VS NON-TRANSECTED BULBAR URETHROPLASTY RESULTS IN SIMILAR STRICTURE RESOLUTION RATE IN PRIMARY REPAIR OF BULBAR URETHRAL STRICTURES

Abstract

You have accessJournal of UrologyTrauma/Reconstruction: Urethral Reconstruction (including Stricture) III1 Apr 2015PD22-02 TRANSECTED VS NON-TRANSECTED BULBAR URETHROPLASTY RESULTS IN SIMILAR STRICTURE RESOLUTION RATE IN PRIMARY REPAIR OF BULBAR URETHRAL STRICTURES Kirk Anderson, Catherine Cooper, Dmitriy Nikolavsky, and Brian Flynn Kirk AndersonKirk Anderson More articles by this author , Catherine CooperCatherine Cooper More articles by this author , Dmitriy NikolavskyDmitriy Nikolavsky More articles by this author , and Brian FlynnBrian Flynn More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.1444AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES There are a wide variety of techniques used in the repair of bulbar urethral strictures. The decision to perform transection vs. non-transection of the corpus spongiosum during urethoplasty is based on stricture characteristics and surgeon preference. A potential benefit of non-transecting technique is preservation of blood supply distal to the site of stricture. The purpose of this study is to review the stricture resolution rate of transecting vs non-transecting urethroplasty utilized by a single surgeon (BJF) to repair bulbar urethral strictures. METHODS A retrospective review was done of 342 patients who underwent anterior urethroplasty performed by a single surgeon over the previous 11 years. Patients were then excluded from further analysis if there had been prior urethroplasty, stricture location outside the bulbous urethra, or age <18 years. In the transected group, surgical techniques used included excision and primary anastomosis (EPA) and augmented anastomosis. In the non-transected group, surgical techniques used included non-transecting anastomotic urethroplasty and dorsal, ventral, or combination dorsal-ventral buccal grafting. The decision which surgical technique to employ was based on stricture etiology, length and surgeon preference. The primary end-point was stricture resolution in transected vs. non-transected bulbar urethroplasty. Success was defined as freedom from secondary procedures including dilation, urethrotomy, or repeat urethroplasty. RESULTS One-hundred and fifty-two patients met inclusion criteria. Mean patient age is 42 years and mean follow-up is 63 months. Primary and secondary outcomes are summarized in Table 1. The most common etiologies are idiopathic and trauma occurring in 59% and 30%, respectively, in the transected group and 60% and 32%, respectively, in the non-transected group. CONCLUSIONS Urethroplasty can be accomplished utilizing a variety of surgical techniques with durable success rates. In this series, transecting and non-transecting bulbar urethroplasty resulted in similar stricture resolution rate. Additional studies are needed to determine if differences may exist in sexual function outcomes and long-term success. Transected Non-Transected p-value Number 102 50 Success 83% 84% 0.92 Stricture Length (range) 2.3cm (0.3-8cm) 3.9 (1-10cm) <0.01 Prior DVIU 51% 54% 0.49 Mean f/u (months, range) 72 (18-137) 45 (2-135) <0.01 © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e476-e477 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Kirk Anderson More articles by this author Catherine Cooper More articles by this author Dmitriy Nikolavsky More articles by this author Brian Flynn More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...