Temporary vesicostomy-assisted urethroplasty for recurrent obliterated posterior urethral stricture.
BACKGROUND
We report the outcomes of temporary vesicostomy- assisted anastomotic urethroplasty in patients with recurrent obliterated posterior urethral stricture.


METHODS
A review of the medical records identified 12 men (mean age 35.8 years) who had undergone anastomotic urethroplasty for recurrent obliterated posterior stricture. Preoperative evaluation of the urethral defect included a simultaneous retrograde urethrogram and cystogram. The mean estimated preoperative radiographic length of the urethral disruption was 4.25 cm. All patients underwent 1-stage bulboprostatic anastomotic repair which was assisted by an intraoperative temporary vesicostomy.


RESULTS
The initial objective success rate was 83%. The mean follow-up was 22 months. Voiding cystourethrography performed postoperatively demonstrated a wide, patent anastomosis in all but two cases. Urethroscopy performed 1 month after surgery revealed a patent anastomosis with normal urethral mucosa in all but two patients. The mean peak flow rate at the last follow-up visit was 16.3 ml/s. Two patients developed an anastomotic stricture 6 weeks after surgery that was successfully treated by direct visual internal urethrotomy. Finally, all patients had a patent urethra after salvage treatment postoperatively.


CONCLUSIONS
An open 1-stage temporary vesicostomy- assisted urethroplasty for recurrent obliterated posterior urethral stricture provides satisfactory outcomes and minimal morbidities.
Division of Urology, Department of Surgery, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan.
Jui-Ming
JM
Liu
Ta-Min
TM
Wang
Yang-Jen
YJ
Chiang
Hsiao-Wen
HW
Chen
Sheng-Hsien
SH
Chu
Kuan-Lin
KL
Liu
Kuo-Jen
KJ
Lin
D000328:Adult; D000368:Aged; D003559:Cystostomy / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods*; D012008:Recurrence; D014521:Urethra / Q000601:surgery*; D014525:Urethral Stricture / Q000601:surgery*