title: A comparison of one-stage procedures for post-traumatic urethral stricture repair.
abstract: OBJECTIVE
  To compare the results and complication rates of various one-stage treatments for repairing a post-traumatic urethral stricture.
  
  
  METHODS
  The medical records of 153 patients who had a post-traumatic urethral stricture repaired between 1977 and 2003 were evaluated retrospectively, and analysed for the different types of urethral reconstruction.
  
  
  RESULTS
  The procedures included direct end-to-end anastomosis in 86 (56%) patients, free dorsal onlay graft urethroplasty using preputial or inguinal skin in 40 (26%), ventral onlay urethroplasty using buccal mucosa in seven (5%) and ventral fasciocutaneous flaps on a vascular pedicle in 20 (13%). At a mean (median, range) follow-up of 75.2 (38, 12-322) months, 121 (79%) patients had no evidence of recurrent stricture, while in 32 men (21%) they were detected at a mean follow-up of 30.47 (1-96) months. Patients having a dorsal onlay urethroplasty had the longest strictures. The re-stricture rate was lowest after a dorsal onlay urethroplasty (5% vs 27% when treated with end-to-end anastomosis, 15% after fasciocutaneous flaps and 57% after a ventral buccal mucosal graft). The surgical technique used had no effect on postoperative incontinence or erectile dysfunction rates.
  
  
  CONCLUSIONS
  In patients with strictures which are too long to be excised and re-anastomosed, tension-free dorsal onlay urethroplasty is better than ventral graft or flap techniques. In patients with short urethral strictures direct end-to-end anastomosis remains an option for the one-stage repair of urethral stricture.
authors.affiliation: Department of Urology, University of Innsbruck, Innsbruck, Austria. andreas.p.berger@uibk.ac.at
authors.forename: Andreas P
authors.initials: AP
authors.lastname: Berger
authors.forename: Martina
authors.initials: M
authors.lastname: Deibl
authors.forename: Georg
authors.initials: G
authors.lastname: Bartsch
authors.forename: Hannes
authors.initials: H
authors.lastname: Steiner
authors.forename: John
authors.initials: J
authors.lastname: Varkarakis
authors.forename: Christian
authors.initials: C
authors.lastname: Gozzi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical / Q000379:methods; D002648:Child; D006801:Humans; D008297:Male; D008875:Middle Aged; D009061:Mouth Mucosa / Q000637:transplantation*; D011183:Postoperative Complications / Q000209:etiology; D012008:Recurrence; D012189:Retrospective Studies; D014521:Urethra / Q000293:injuries*; D014525:Urethral Stricture / Q000503:physiopathology / Q000601:surgery*; D014554:Urination / Q000502:physiology; D014563:Urodynamics