title: Reconstruction of posterior urethral disruption injuries: outcome analysis in 82 patients.
abstract: OBJECTIVE
  We sought to identify the long-term success rate of perineal anastomotic reconstruction for posterior urethral disruption.
  
  
  METHODS
  We reviewed the records of 82 patients with traumatic prostatomembranous urethral strictures who underwent perineal anastomotic urethroplasty by 1 surgeon.
  
  
  RESULTS
  Excision of fibrosis with simple perineal anastomosis was performed in 52 patients (63%), while pubectomy was required in 30 (37%) to obtain a tension-free anastomosis. Median followup was longer than 1 year. Potency improved from 46% before reconstruction to 62% postoperatively. Nine patients (11%) required 1 endoscopic urethrotomy after urethroplasty to improve flow rate and this procedure was successful in 8 (88%). In 3 patients (3%) urethroplasty ultimately failed and they remained untreated because of insurmountable co-morbidity. Overall, long-term success was observed in 79 patients (97%).
  
  
  CONCLUSIONS
  Excellent long-term results can be expected from anastomotic urethroplasty in patients with traumatic posterior urethral strictures. Subsequent urethrotomy, when required, has a high likelihood of success. A significant number of patients regain potency after urethral reconstruction. Persistent impotence probably reflects the severity of pelvic trauma.
authors.affiliation: Department of Urology, University of California School of Medicine, San Francisco, USA.
authors.forename: A F
authors.initials: AF
authors.lastname: Morey
authors.forename: J W
authors.initials: JW
authors.lastname: McAninch
mesh_terms: D006801:Humans; D008297:Male; D013514:Surgical Procedures, Operative / Q000379:methods; D016896:Treatment Outcome; D014521:Urethra / Q000293:injuries* / Q000601:surgery*