title: Perineal anastomotic urethroplasty for posttraumatic urethral stricture with or without previous urethral manipulations: a review of 61 cases with long-term followup.
abstract: OBJECTIVE
  We retrospectively analyzed cases of anastomotic urethroplasty for posttraumatic urethral strictures that were done at our center. Surgical and functional outcomes were evaluated. The impact of previous urethral manipulations was assessed.
  
  
  METHODS
  Between 1993 and 2006, 61 males were treated with anastomotic urethroplasty because of urethral trauma after pelvic fracture. Mean followup was 67 months (range 19 to 173). In 21 of the 61 cases (34.4%) urethral manipulation had been performed previously (secondary cases) but had failed. All patients were treated via the perineal approach.
  
  
  RESULTS
  In 9 patients (14.8%) recurrence was reported. The recurrence rate was higher in patients who underwent former treatment than in primary patients (19% vs 12.5%). Posttraumatic impotence was reported by 20 patients (32.8%) but in 2 erectile function was restored after treatment. One patient had minor stress incontinence. In 2 secondary cases the rectum was injured during the procedure but could be repaired.
  
  
  CONCLUSIONS
  Anastomotic urethroplasty via the perineal approach is an excellent treatment for posttraumatic urethral stricture. Results are good at long-term followup. Although statistical significance has not been attained, failures and complications seem to be higher in patients who have already undergone failed urethroplasty.
authors.affiliation: Department of Urology, Ghent University Hospital, Ghent, Belgium.
authors.forename: Nicolaas
authors.initials: N
authors.lastname: Lumen
authors.forename: Piet
authors.initials: P
authors.lastname: Hoebeke
authors.forename: Bart De
authors.initials: BD
authors.lastname: Troyer
authors.forename: Barbara
authors.initials: B
authors.lastname: Ysebaert
authors.forename: Willem
authors.initials: W
authors.lastname: Oosterlinck
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013997:Time Factors; D014521:Urethra / Q000293:injuries* / Q000601:surgery*; D014525:Urethral Stricture / Q000209:etiology* / Q000601:surgery*; D055815:Young Adult