Outcomes of grafted bulbar urethroplasty in men with class II or III obesity.
OBJECTIVE
To evaluate the outcomes of grafted bulbar urethroplasty in class II or III obese patients.


METHODS
Retrospective chart review was performed for men with World Health Organization class II/III obesity undergoing grafted urethroplasty for management of bulbar strictures from 2003-2010. Extracted data included age, body mass index (BMI), stricture etiology, stricture length/location, number/type of previous therapies, definitive therapy, follow-up, outcome, and complications. Outcomes were compared with a cohort of 20 age-matched nonobese men with bulbar strictures managed with grafted urethroplasty.


RESULTS
Fifteen class II/III obese men were included in the study. Obese patient age (43.8 years, range 27-60) and BMI (44.0 kg/m(2), range 35-57) were averaged. Each patient reported a mean of 3.8 previous dilations or urethrotomies (range 0-9). All men were treated with grafted bulbar urethroplasty (11 ventral, 4 dorsal) with oral mucosa (13 buccal, 2 lingual). After a mean follow-up of 29.4 months (range 7-62), the urethral patency rate was 66.7% (10/15). Complications included prolonged urethral leak in 5/15 (33%) and wound infection in 5/15 (33%) patients. Urethral patency rates and complications were significantly higher in class II/III obese patients when compared with the nonobese cohort.


CONCLUSIONS
Obese men demonstrated poorer outcomes after grafted bulbar urethroplasty when compared with published success rates in the general population as well as an aged-matched, nonobese cohort from our institution. Prior failed endoscopic procedures and other medical comorbidities may have also contributed to the observed results in this patient population.
Department of Urology, Medical College of Wisconsin, Milwaukee, WI 53226, USA.
Jamie R
JR
Privratsky
Nima
N
Almassi
Michael L
ML
Guralnick
Bradley J
BJ
Anderson
R Corey
RC
O'Connor
D000328:Adult; D015992:Body Mass Index; D016022:Case-Control Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009061:Mouth Mucosa / Q000637:transplantation*; D009765:Obesity / Q000150:complications*; D011183:Postoperative Complications / Q000209:etiology*; D012008:Recurrence; D012189:Retrospective Studies; D016896:Treatment Outcome; D014525:Urethral Stricture / Q000601:surgery*