You have accessJournal of UrologyTrauma/Reconstruction: Traum & Reconstructive Surgery (1)1 Apr 20137 ANASTOMOTIC RECONSTRUCTION OF RADIOTHERAPY INDUCED POSTERIOR URETHRAL STENOSIS Lee C. Zhao, Allen F. Morey, Matthias D. Hofer, J. Francis Scott, Christopher M. Gonzalez, and Steven B. Brandes Lee C. ZhaoLee C. Zhao Dallas, TX More articles by this author , Allen F. MoreyAllen F. Morey Dallas, TX More articles by this author , Matthias D. HoferMatthias D. Hofer Chicago, IL More articles by this author , J. Francis ScottJ. Francis Scott Dallas, TX More articles by this author , Christopher M. GonzalezChristopher M. Gonzalez Chicago, IL More articles by this author , and Steven B. BrandesSteven B. Brandes St. Louis, MO More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.1381AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The efficacy of anastomotic urethroplasty for radiotherapy induced proximal urethral stenosis has been questioned (BJU Int 2012; 110, 304-325). We describe the results of a multi-institutional experience of anastomotic urethroplasty in this setting. METHODS We reviewed of urethroplasty for radiotherapy induced bulbomembranous stenosis at 3 institutions was performed. All patients with greater than 6 months follow up were included. Surgery involved complete scar excision, urethral mobilization, and bulbomembranous primary anastomosis. Patient characteristics and surgical parameters were reviewed. Recurrence was defined as cystoscopic identification of urethral narrowing to less than 16Fr in diameter. RESULTS Among 78 men treated, 72 (92%, mean age 69.5 years) underwent anastomotic reconstruction at 3 institutions. Successful bulbomembranous urethral reconstruction was achieved in 52 men (72%) at a mean follow up of 2.7 years. Mean stricture length was 2.4 cm (range 1 to 6). Hospitalization was one day or less for 75% of the patients. Many patients had incontinence preoperatively (25/72, 34%). After surgery, incontinence was present in 23 (32%), and new onset incontinence in 14 (19%), with 12 (17%) requiring an artificial urinary sphincter. The rate of erectile dysfunction was unchanged following urethroplasty (48% preoperative, 52% postoperative). Prostate cancer treatment was the most common reason for radiotherapy (70/72, 97%); within this group, external beam radiotherapy was performed in 30 men (42%), brachytherapy in 31 (43%), and a combination of the 2 modalities in 10 (14%). Two patients who underwent radiotherapy for colorectal cancer were also included. The type of radiotherapy, external beam or brachytherapy, did not affect stricture length (2.4 cm vs 2.2 cm, p=0.42) or risk for recurrence (27% vs 29%, p=0.93). Of the 20 men with recurrence, mean time to stricture recurrence was 10 months (range 1 to 64). CONCLUSIONS While the results are not as reliable as posterior urethroplasty for pelvic fracture related urethral injuries, radiotherapy induced strictures can often be successfully treated by urethroplasty without tissue transfer techniques. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e3 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Lee C. Zhao Dallas, TX More articles by this author Allen F. Morey Dallas, TX More articles by this author Matthias D. Hofer Chicago, IL More articles by this author J. Francis Scott Dallas, TX More articles by this author Christopher M. Gonzalez Chicago, IL More articles by this author Steven B. Brandes St. Louis, MO More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...