title: Urethroplasty after radiation therapy for prostate cancer.
abstract: OBJECTIVE
  To report urethroplasty outcomes in men who developed urethral stricture after undergoing radiation therapy for prostate cancer.
  
  
  METHODS
  Our urethroplasty database was reviewed for cases of urethral stricture after radiation therapy for prostate cancer between June 2004 and May 2010. Patient demographics, prostate cancer therapy type, stricture length and location, and type of urethroplasty were obtained. All patients received clinical evaluation, including imaging studies post procedure. Treatment success was defined as no need for repeat surgical intervention.
  
  
  RESULTS
  Twenty-nine patients underwent urethroplasty for radiation-induced stricture. Previous radiation therapy included external beam radiotherapy (EBRT), radical prostatectomy (RP)/EBRT, EBRT/brachytherapy (BT) and BT alone in 11 (38%), 7 (24%), 7 (24%), and 4 (14%) patients, respectively. Mean age was 69 (±6.9) years. Mean stricture length was 2.6 (±1.6) cm. Anastomotic urethroplasty was performed in 76% patients, buccal mucosal graft in 17%, and perineal flap repair in 7%. Stricture was localized to bulbar urethra in 12 (41%), membranous in 12 (41%), vesicourethra in 3 (10%), and pan-urethral in 2 (7%) patients. Overall success rate was 90%. Median follow-up was 40 months (range 12-83). Time to recurrence ranged from 6-16 months.
  
  
  CONCLUSIONS
  Multiple forms of urethroplasty appear to be viable options in treating radiation-induced urethral stricture. Future studies are needed to examine the durability of repairs.
authors.affiliation: Department of Urology, University of California, San Francisco, San Francisco General Hospital, San Francisco, California 94117, USA.
authors.forename: Allison S
authors.initials: AS
authors.lastname: Glass
authors.forename: Jack W
authors.initials: JW
authors.lastname: McAninch
authors.forename: Uwais B
authors.initials: UB
authors.lastname: Zaid
authors.forename: Nadya M
authors.initials: NM
authors.lastname: Cinman
authors.forename: Benjamin N
authors.initials: BN
authors.lastname: Breyer
mesh_terms: D000368:Aged; D006801:Humans; D008297:Male; D008875:Middle Aged; D011471:Prostatic Neoplasms / Q000532:radiotherapy*; D011878:Radiotherapy / Q000009:adverse effects; D016896:Treatment Outcome; D014521:Urethra / Q000601:surgery*; D014525:Urethral Stricture / Q000209:etiology / Q000601:surgery*; D016741:Urinary Sphincter, Artificial