Transpubic urethroplasty for complex posterior urethral strictures: a single center experience.
OBJECTIVE
To review our experience and outcome of transpubic urethroplasty for complex posterior urethral strictures.


METHODS
19 patients, mean age 17.8 (6-35) years, were treated with transpubic urethroplasty over the last 6 years. All had traumatic etiology (15 due to road traffic accidents and 4 due to falls from height). Mean stricture length was 4.4 (3.0-6.0) cm. All had a history of some intervention earlier. Three had rectourethral fistula, and 2 sinus tract in perineum which was connected to the periurethral cavity. One had a long fistulous tract connected through the anus to the anterior abdominal wall. One patient each had urethrocutaneous fistula, periurethral cavity and osteomyelitis of the pubic bone.


RESULTS
16 of 19 (84.2%) patients had excellent outcomes with no evidence of stricture. Three had acceptable outcomes with some evidence of stricture. The mean operative time was 3.2 (2.5-4.0) h and average blood loss was 650 (500-900) ml. The mean hospital stay was 7.6 (6-12) days and average follow-up was 30 (7-66) months. Two patients developed mild wound infection. One patient each developed epididymoorchitis, perineal hematoma, fecal fistula and urine leak. One patient failed to void, and one patient developed erectile dysfunction.


CONCLUSIONS
Transpubic urethroplasty is an excellent approach for patients with complex posterior urethral strictures.
Gupta
N P
NP
Department of Urology, All India Institute of Medical Sciences, New Delhi, India. narmadagupta@gmail.com
Mishra
S
S
Dogra
P N
PN
Yadav
R
R
Seth
A
A
Kumar
R
R
D000293:Adolescent; D000328:Adult; D002648:Child; D006801:Humans; D008297:Male; D014521:Urethra / Q000293:injuries / Q000601:surgery*; D014525:Urethral Stricture / Q000209:etiology / Q000601:surgery*; D013521:Urologic Surgical Procedures, Male / Q000379:methods; D055815:Young Adult