Urethroplasty- a single centre single surgeon experience

McNicholas, Daniel Peter; Taylor, Alexander; Baird, Andrew D.

Abstract

Introduction Male urethral stricture affects 100 in 100,000 men. These are investigated using uroflowmetry, retrograde
urethrography and cystourethroscopy. Management is usually endoscopic with urethral dilation or direct visual internal
urethrotomy, although they have high failure rates. It is now recommended that urethroplasty is performed earlier. In this
study we have reviewed a single surgeons experience with urethroplasty and patient outcomes.
Methods We retrospectively reviewed a prospectively maintained database of all urethroplasty operations performed in our
hospital over a 5 -year period.
Results Forty-five patients were identified, with a mean age of 46. The most common presenting symptom was poor flow
(100%). Uroflowmetry was performed in 31 of 45 patients(69%). More patients had a urethrogram (58%) than flexible cys-
toscopy (38%). Most strictures were idiopathic (67%). Mean stricture length was 2.6 cm. 71% did not require any further
intervention. Five patients required repeat surgery. Four required DVIU and one required a repeat urethroplasty.
Discussion The most popular techniques for urethroplasty in the UK are augmentation urethroplasty using a buccal mucosal
graft and anastomotic urethroplasty, both of which we describe. There are variations in what is deemed as successful surgery.
The most widely used definition is ‘the lack of need for any further operative intervention’. We have recently adopted Patient
Reported Outcome Measures using a validated questionnaire to measure the patients perception of a successful outcome.
Complex strictures have a higher incidence of complications. 42% of our cohort were complex and we describe results
comparable to the published literature.

Citation

McNicholas, D. P., Taylor, A., & Baird, A. D. (2024). Urethroplasty- a single centre single surgeon experience. Irish Journal of Medical Science, https://doi.org/10.1007/s11845-024-03798-z

• Journal Article Type: Article
• Acceptance Date: Aug 23, 2024
• Online Publication Date: Sep 3, 2024
• Publication Date: Sep 3, 2024
• Deposit Date: Sep 5, 2024
• Publicly Available Date: Sep 5, 2024
• Journal: Irish Journal of Medical Science (1971 -)
• Print ISSN: 0021-1265
• Electronic ISSN: 1863-4362
• Publisher: Springer Verlag
• Peer Reviewed: Peer Reviewed
• DOI: https://doi.org/10.1007/s11845-024-03798-z