Outpatient anterior urethroplasty: outcome analysis and patient selection criteria.
OBJECTIVE
We compared the outcomes of anterior urethroplasty for stricture disease performed on an outpatient and an inpatient basis.


METHODS
We reviewed the records of 78, 1-stage anterior urethroplasties performed via excision with primary anastomosis, buccal mucosal graft or penile fasciocutaneous skin flap techniques from September 1997 to December 2000 by a single surgeon (A. F. M.). All patients had more than 1 year of followup (range 1 to 4.5). Of the graft procedures only those in the bulbar urethra were included in analysis. Outpatient procedures were defined as those in which the patient was discharged home within 24 hours. Clinical outcome was considered a failure when instrumentation was required postoperatively.


RESULTS
Of the 78 anterior urethral repairs 54 (69%) were performed on an outpatient basis, including 50 (93%) in which the outcome was successful compared with 88% (21) of the 24 inpatient procedures. Excision with primary anastomosis had the highest outpatient rate (28 of 31 patients or 90%), followed by penile skin flaps (16 of 25 or 64%) and buccal mucosal grafts (10 of 22 or 45%). Patient characteristics were significantly associated with outpatient procedures, including younger mean age (36 versus 46 years), shorter mean stricture length (3.1 versus 6.6 cm.) and shorter mean operative time (3.2 versus 4.66 hours) (p <0.05).


CONCLUSIONS
Anterior urethral reconstruction can often be completed safely and effectively on an outpatient basis.
Urology Service, Brooke Army Medical Center, San Antonio, TX, USA.
Jack B
JB
Lewis
Kelly A
KA
Wolgast
John A
JA
Ward
Allen F
AF
Morey
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000556:Ambulatory Surgical Procedures; D000714:Anastomosis, Surgical; D002648:Child; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009092:Mucous Membrane / Q000637:transplantation; D015999:Multivariate Analysis; D018579:Patient Selection; D012189:Retrospective Studies; D016038:Skin Transplantation; D013524:Surgical Flaps; D016896:Treatment Outcome; D014521:Urethra / Q000601:surgery*; D014525:Urethral Stricture / Q000473:pathology / Q000601:surgery*