Does a previous end-to-end urethroplasty alter the results of redo end-to-end urethroplasty in patients with traumatic posterior urethral strictures?
OBJECTIVE
To evaluate the success rate of redo anastomotic urethroplasty and to compare it with primary anastomotic urethroplasty.


METHODS
We compared 52 patients with post-traumatic posterior urethral strictures (group 1, mean age 24.6 years, range 10-62) who had undergone redo urethroplasty with 66 patients (group 2, mean age 22.6, range 6-71) who had undergone primary anastomotic urethroplasty. Mean stricture length was 2.0 cm (1-4.5) and 2.5 cm (1.5-6), respectively. All of the patients in group 1 had a stricture located at the bulboprostatic anastomotic site. In group 2, 43 (65.2%) had a bulbomembranous stricture and 23 (34.8%) had a prostatomembranous stricture.


RESULTS
Mean operative time was 140 (100-240) and 90 min (75-200) in group 1 and 2, respectively. Mean blood loss was 180 (80-900) and 125 mL (50-700), respectively. Mean hospital stay was comparable (6.6 days vs 5.5 days) between the two groups. Mean follow up was 54 months (10-144) for group 1 and 62 months (12-122) for group 2. Corporal separation, inferior pubectomy, a transpubic approach and urethral rerouting were required in 22 (42.3%) and 12 (18.2%), 7 (13.5%) and 3 (4.5%), 12 (23%) and 5 (7.6%), 2 (3.8%) and nil patients in group 1 and 2, respectively. An excellent or acceptable outcome was achieved in 42 (80.8%) and 57 (86.4%), 8 (15.4%) and 7 (10.6%) patients, respectively. Two patients in each group failed.


CONCLUSIONS
Previously failed end-to-end urethroplasty does not alter the success rate of redo end-to-end urethroplasty.
Gupta
Narmada P
NP
Department of Urology, All India Institute of Medical Sciences, New Delhi, India. narmadagupta@hotmail.com
Mishra
Saurabh
S
Dogra
Prem N
PN
Hemal
Ashok K
AK
Seth
Amlesh
A
Kumar
Rajeev
R
D000293:Adolescent; D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical; D002648:Child; D006801:Humans; D008297:Male; D008875:Middle Aged; D012086:Reoperation; D016896:Treatment Outcome; D014521:Urethra / Q000293:injuries* / Q000601:surgery*; D014525:Urethral Stricture / Q000209:etiology* / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000379:methods; D055815:Young Adult