Anastomotic urethroplasty for bulbar urethral stricture: analysis of 168 patients.
OBJECTIVE
We reviewed our experience with anastomotic urethroplasty for anterior urethral stricture.


METHODS
A chart review revealed 168 patients 6 to 82 years old (mean age 38) with at least 6 months of followup (mean 70, range 6 to 291) after anastomotic urethroplasty.


RESULTS
Average stricture length was 1.7 cm. Of the 168 patients stricture recurred in 8 (5%) but was managed by direct vision internal urethrotomy or a single dilation in 5, while repeat urethroplasty was required in 3 (2%). In these 3 cases extenuating circumstances included patient dislodgment of the catheter with attempts to replace it that disrupted repair, a history of urethrocutaneous fistula and periurethral abscess, and previous irradiation complicating the stricture in 1 each. Other complications were uncommon, such as transient thigh pain or numbness in 3 patients (2%), small wound dehiscence in 2 (1%), and scrotal hematoma, erectile dysfunction and self-limited pulmonary edema in 1 (less than 1%) each.


CONCLUSIONS
Anastomotic urethroplasty for anterior stricture has a high success rate of 95%. It is technically straightforward and complications are uncommon. Cure by anastomotic urethroplasty should be strongly favored over long-term management by direct vision internal urethrotomy or dilation.
Santucci
Richard A
RA
Department of Urology, University of California School of Medicine and Urology Service, San Francisco General Hospital, San Francisco, California, USA.
Mario
Layla A
LA
McAninch
Jack W
JW
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical; D002648:Child; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D014521:Urethra / Q000601:surgery*; D014525:Urethral Stricture / Q000601:surgery*