title: Urethral ultrasound as a screening tool for stricture recurrence after oral mucosa graft urethroplasty.
abstract: OBJECTIVE
  To evaluate the efficacy of sonourethrography (SUG) in combination with voiding pattern analysis to determine success after oral mucosa graft (OMG) urethroplasty. OMG urethroplasty is a standard treatment for men with recurrent urethral stricture. Because of its performance, the optimum follow-up algorithm remains controversial.
  
  
  METHODS
  Forty-nine patients (mean age 51 years) who underwent OMG urethroplasty were retrospectively identified. All men were subjected to a validated voiding questionnaire (International Prostate Symptom Score [IPSS]), SUG, uroflowmetry, and residual urine measurement. The predictive value was analyzed with regard to stricture recurrence or patency as well as to urethral diameter. Retrograde urethrography was done to confirm the diagnosis.
  
  
  RESULTS
  Strictures were bulbar in 39, penile in 4, and combined in 6 patients. Mean stricture length was 3.8 cm (range 1-10). Mean follow-up after surgery was 35 (range 15-70) months. SUG showed a mean diameter of 7.6 mm for bulbar grafts and 4.6 mm for penile grafts. Stricture recurrence was seen in 4 (8%) patients, yielding a significantly lower urethral width of 2.3 mm (P<.005). Retrograde urethrography confirmed the patency status in all. The average maximum flow rate after successful repair was 36.6 mL/s, whereas those with recurrent strictures showed rates of 11.2 (P<.03). Similar results were achieved for residual urine (P<.05). IPSS values increased from 5.1 to 12.5 in patients with recurrence (P<.01).
  
  
  CONCLUSIONS
  An algorithm consisting of SUG, uroflowmetry, residual urine and IPSS assessment reliably identifies stricture recurrence. Routine retrograde urethrography may therefore be unnecessary in the follow-up of OMG urethroplasty.
authors: Department of Urology, Eberhard-Karls University, Tuebingen, Germany.
authors: Joerg
authors: J
authors: Seibold
authors: Maren
authors: M
authors: Werther
authors: Saladin
authors: S
authors: Alloussi
authors: Tilman
authors: T
authors: Todenhöfer
authors: Georgios
authors: G
authors: Gakis
authors: Stefan
authors: S
authors: Aufderklamm
authors: David
authors: D
authors: Schilling
authors: Arnulf
authors: A
authors: Stenzl
authors: Christian
authors: C
authors: Schwentner
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D006801:Humans; D008297:Male; D008875:Middle Aged; D009061:Mouth Mucosa / Q000637:transplantation*; D019651:Plastic Surgery Procedures; D012008:Recurrence; D014463:Ultrasonography; D014521:Urethra / Q000000981:diagnostic imaging* / Q000601:surgery; D014525:Urethral Stricture / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery; D014563:Urodynamics; D055815:Young Adult